Over the last month, the Food and Drug Administration has been pushing Congress to encourage MAT Programs in more states around the country.
What is MAT, you ask? MAT Programs stand for Medication-Assisted Treatment. Or, in other words, prescribing opioid addicts medications such as methadone, buprenorphine (Suboxone), and naltrexone, as an attempt to combat the current opioid epidemic.
FDA Commissioner Scott Gottlieb stands by the organization’s decision to promote MAT, as the reported evidence from research are “overwhelming”. According to data released and even reviews of the research that are supported by WHO, the CDC, and the National Institute on Drug Abuse, MAT Programs have the potential to cut All-Cause deaths in half or more.
** All-Cause deaths refers to the total numbers of deaths due to a condition during a specific time frame.
Medical Condition Rather Than Moral Failure
This topic has been causing a lot of debate in the world of recovery, and lawmakers and pharmaceutical companies. There has, for a long time, been a discussion over whether addiction was an actual medical condition or if it was just behavior resulting from lack of moral character or a strong power of will.
One side of the debate is sure that MAT Programs are simply allowing the replacement of one addiction with another, while the other side is sure that the loss of lives and the maintained prescriptive control of the medication will be enough to sway the scales on the opioid epidemic.
One of the nation’s top substance abuse and addiction treatment centers, The Hazelden Betty Ford Foundation, was a long time subscriber to the method of abstinence and the active working of a 12 step program. Many would agree, that their success using that method alone was what would lead them to become the nation’s top substance abuse treatment facilities, but in 2012, they signed on to the idea of MAT Programming.
According to Marvin Seppala, Chief Medical Officer at Hazelden, “This is a huge shift in our culture and organization… We believe it is the responsible thing to do.”
Compare and Contrast:
There are a lot of different levels of MAT Programming, and for ensuring the safety and quality of its process. For example, the Hazelden Foundation only administers MAT to patients who are to be enrolled in long-term, inpatient treatment. In conjunction with multiple types of therapy and a rigorous 12 step program, they have begun to see, according to Seppala, astounding results.
Some surface level benefits of MAT Programs are:
- Decreased death rates due to overdose
- Decreased levels of IV users, possibly preventing HIV and AIDS rise
- Potential for user to stay off “street drugs”, allowing time to explore 12 step options and other recovery focused communities
- A greater understanding of the medical condition of addiction, rather than the previous stigma of a moral failing
- Ability for users to receive multiple levels of treatment and therapy during early stages of recovery
And for the Disadvantages…
- Many people who are already using opioids or heroin may try to abuse the system if there are options to receiving the MAT Program outside of treatment, i.e., methadone clinics.
- There can be a danger if people with co-occurring disorders are taking medications (such as those for anxiety, depression, bi-polar) go onto the MAT Program. This can create serious risks for people who are prescribed or recreationally use benzodiazepines in particular.
- There could potentially be a decreased desire to pursue treatment or long-term sobriety options such as 12 step programs.
- How much room will there be for lawmakers to constrict the amounts and frequency that a person receives their medication? Some users are worse than others, and present varying levels of mental conditions and addiction levels, creating potential gaps in the availability and eligibility of some users in comparison to others.
The main concerns here are, outside of the treatment setting, if the FDA approves MAT Programs nationwide, will there be a lot of opportunities for people to find loopholes in the system?
Will there be a database that will require all MAT Program users to be enrolled in, as a way for prescribers to ensure safe and controlled using, as well as ensuring that the user is maintaining some sort of sobriety aside from the controlled substances?
Will there be any other requirements put on the patients? Similar to something like checking in with a probation officer, but in this case, checking in with a “sobriety coach” of sorts? Ensuring they are attending meetings, staying off other drugs and alcohol, maintaining their day to day responsibilities, urine analysis, etc.?
Are MAT Programs only going to be allowed in treatment centers and substance abuse facilities, or will they be similar to a “safe-using” facility like we have seen throughout Europe, where people can come and go as they please for their “medication”?
All of these questions generally arise out of the line of thought that many users will be happy to go on the MAT Program, especially if there are ways for the system to be manipulated.
Methadone clinics have been around for decades, resulting in many people just becoming completely and utterly dependant on methadone. So if this type of MAT Program exists out there, outside of a structured treatment setting, is this not just going to perpetuate that cycle?
- Will people be receiving MAT through out-of-pocket payment, or will there be an entirely new level of insurance coverage that will go towards funding MAT Programs?
- In that light, if it will only be available through substance abuse treatment, will treatment be made more readily available for people who cannot attend treatment through lack of proper health care coverage?
Obviously, there is a lot of room for questions and debate here. In the early stages of the FDA’s announcement and their desire to enforce and encourage MAT Programs, there will be a good deal of discussion and laws passed through Congress (hopefully) that will help structure and organize the programs to ensure that they are actually being used successfully.
Of course, there will be issues of funding, and with President Trump’s recent declaration of the opioid epidemics level of a National Health Emergency, there has been a lot of debate on different ways to deal with the issue.
However, the declaration does not endorse any increased funding to go towards the crisis, but rather a redistribution of funds that are already available. So with the MAT Program, and the potential it DOES have to bring about some actual change in the battle against the opioid epidemic, there will have to be some pretty strict and enforced rules that come along with it.
Seeking Treatment For Alcoholism or Addiction
If you find that you cannot stop using drugs or alcohol even though you would like to, then you may be suffering from an addiction. Addiction is an actual, recognizable disease and as such, you’re inability to stop on your own should not be a cause for shame or guilt. There are millions of people every year who need to seek help for addiction and alcoholism, and many have made it through their struggles to a life of recovery. So if you think you need help, then call the professionals at Dream Center for Recovery today at 1-877-978-3148. Our trained staff is standing by to take your call and discuss your drug and alcohol treatment options.