AfterParty Answers: What is Medication-Assisted Treatment?

AfterParty Answers: What is Medication-Assisted Treatment?

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AfterPartyOver here at AfterParty, we receive an onslaught of questions from people about addiction and recovery. And well, our new video series AfterParty Answers gives us an opportunity to address them. In this episode, Anna David and Danielle Stewart reach into the AfterParty archives to answer a reader’s question about medication-assisted treatment, also known as opiate replacement therapy, also known as an issue we’ve covered extensively here on AfterParty Magazine.

So what is opiate replacement therapy or medically-assisted treatment or medically-assisted therapy (or MAT if you’re into abbreviations)? In addition to being the current political hot button issue (with Hillary Clinton proposing to put $10 billion to put MAT in most rehabs), it’s a concern that those in the treatment world grapple with every day. The main question is this: should opiate addicts be put on Suboxone or methadone in order to stay off of, say, heroin or Oxycontin?

One side argues that since Suboxone is an opiate, the people taking it are getting high (and, indeed, there are plenty of folks who can attest to the fact that detoxing off Suboxone is harder than getting off heroin). The other side believes that putting junkies on Suboxone as a way of preventing them from going back to heroin can be life-saving. (It’s important to point out here that medically assisted detox—that is, using Suboxone or methadone to help someone get off opiates—is entirely different from staying on Suboxone indefinitely.)

Even more controversy exists when you get into the debate about whether or not Sub-takers are “sober” or “in recovery.” What, in short, is sobriety and is it something a person can decide for him or herself?

While we aren’t in any way medical professions (emphasis on “aren’t in any way medical professionals”), we are sober folks who have not only grappled with some of the issues being asked about but have also written scads of articles for this very site on them. So here we are presenting our answers to you in our video series AfterParty Answers. Tune in every Wednesday to see what you, our faithful readers, want to know.

Want to see all of our AfterParty Answers videos? Good news! You can simply click here!

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3 Comments

  1. So yeah, not drinking anymore. No longer passed out in the backyard minefield where the emotionally starved sexually abused dog spends most of it’s life, almost making it in the house. Put that demon alcohol to rest finally. Yep.. A few weeks of court ordered counseling makes you a recovery hero of sorts. Plus! adding to the asset column, some time has passed since calling your partner a fat ugly C-word in front of the kids so, your slate isn’t clean really but it’s swept off sort of. I mean you’re not trusted by any means you’re tolerated. The rest of your dysfunctional family is going back to the usual inner pain and suffering that dominated them before your latest B movie directorial. Nobody is getting an obvious emotional beating anymore. The new subtle thing, the silent scorn or silent treatment keeps the cops away so hey, life is good. This new behavior is your interpretation of the counselor’s suggestion to just walk away before you go off crazy. Remind yourself! The horror of a drunken madman left with the bottle. Yup. The booze was the problem. Booze is bad. Don’t drink booze. Who’d a thought?. …………………………………………………………

    Now what…Nobody knows the latest secret squirrel move. The power of the 80 milligram coping skill. For Daddy’s eyes only. The basement bathroom is the perfect place to stash the oxy 80’s. Up on the ceiling tile.. Lets go! Get up? Get coffee? Head downstairs and take one of those tiny 60 buck morsels (a smiling super deal) out of the bag. Uh, 60 bucks buys a lot of other important stuff sure but when everyone else pays 80 a milligram and you score a half a script for 60 a piece? Easily a months rent and then some? Who cares if the car insurance is canceled. This is you now, your world, the mirror in the bathroom. You look good and freedom awaits. Hurry up. Roll it around in your mouth for a few seconds to get that pesky coating off then slice and dice 2 big fat lines of opportunity on the smooth vanity countertop. The clean spot. A few minutes later? A full on participant. A working guy, a real man. The alpha. No first time caller long time listener here, no. You’re the man! You are in the easy pass lane now. ……………………………………………………………………………..

    Nor drinking has it’s benefits for sure especially if you’re still doing opiates daily. There’s the many plans made, promises to others, grand delusions that never seem to materialize but sure do sound good at the time. You don’t get it. You don’t get that you are two completely different people. One person is waiting to get high and the other is waiting to come down. Everyday. First and foremost you get high to see yourself at the little league game, see yourself painting the livingroom wall that you stained with burnt turkey last thanksgiving drunk. Yup, you get high and are all things to all people. They all like you, how could they not?………………………………………………………………………………….

    The gradual spiral into this empty void can take a bit of time. You can stall as long as you get dope. Jockey for position, make new arrangements, dictate authority. As you begin to get noticed, caught up, as you trip up maybe run out of money. Others get wise to you. You admit defeat, throw yourself sniffling and whimpering at the mercy of the family in good junkie fashion. Exposed now you go to the Doctor and offer full discloser. That and family support gets you suboxone. …………………………………………………………………………..

    Now with the suboxone and the scattered rubble of what was your life, you begin the road of reconstruction ahead. This is going to be new. This isn’t you going back to when you think you had it together or before booze and drugs somehow destroyed your life, nope..This is brand new. A new beginning. You’re wise to double even triple up on therapy. Maybe meetings and that whole thing. Whatever it takes to stop lying and stealing life from others. Whatever it takes to just be a part of living with nothing to steal. Whatever it takes to learn to give. Suboxone can provide a new beginning for sure it’s just to qualify? You have to be pretty badly mangled. For those who admit hopelessness? Subs can work, offering a new lease on life.

  2. Well? Facts and figures, Google friendly pictures and diagrams, studies from a basement silk upholstered chair. What does this whole assisted medication look like in real time? Right now face to face? It looks like this. …………………………………………………

    You take one junkie of the hopeless variety. Generally speaking a physically addicted, mentally obsessed, emotionally starved around the clock opiate user. The one who has lost the power of choice, who can no longer take it or leave it alone. Basically? Drugs come first, absolutely first. They are gone in the head, invisible to themselves, no reflection..mush. Burnt. Full flight from reality living in their delusion that only allows them the freedom to think with sufficient clarity when the drug induced window is kicked open, open wide and almost closed. Now, if you catch them when they are high or lets say emotionally relieved? To them a desperately desired state of being, when, oh yeah sure the world is crumbling around them but with 40 milligrams of coping skill they are high and once again functioning? This is life. We all rely on some form of denial, some sufficient excuse for who or what they are and their perception of things. That whole it (is what it is) thing or (I just do what I gotta do) mindset which usually amounts to a lot of nothing good for anyone including me. ………………………………………………………….

    Now..To those watching , this is just plain insanity. From the cheap seats usually distanced for good reason from the junkie, you watch as he settles for less and less, losing more and more of themselves. They are seemingly under constant attack from life. Jobs, families, fragments of emotional security. they run from themselves in hopes of finding themselves? The circle of life on opiates. They are near death and..Oh look! A nickel! completely detached wandering around in search of new stimulus to control. Like the song say’s(you ain’t goin nowhere)…………………………………………………………………………….

    So.. enter the cure, Suboxone. Forget Methadone it’s outdated garbage, like antabuse to the drunk..It had it’s place for years whether on the German Nazi war front of WW2 or pushed by Big Pharma as the only real alternative to heroin addiction in the Governments war on junkies since. Another tracking device. But Suboxone? Different animal, it eliminates withdrawal basically right away. Get a haircut and a real job? So the addict who was spiraling into nothingness stops spiraling. Stops dead in their tracks and is forced into some form of accountability which more than not is accepted as their new survival mode.. They can be redirected in this moment of assumed clarity. That whole stop digging chestnut. Many can immediately begin to retain and apply once the overwhelming or dominating constant need for dope is no longer there. They are amazed, teachable on Suboxone. I myself have witnessed this enough to become open minded even though I myself am Big Book 12 Steps in which abstinence is suggested. Big Book 12 Steps is certainly not for everybody who suffers in alcoholic hopelessness. It’s my thing. Tailor made for me and my kind. ………………………………………………

    Now I have also been involved with people who have been on Suboxone for many years. Who were the first to speak of the wonder drug you put under your tongue each day and (BAM) go to work or face many other responsibilities that had become intolerable without some form of opiate for support. So you have a runny nose, so you wipe your ass 25 times, small price to pay. Is this good or bad on the long term I don’t know. It would appear to me that now that the junkie is no longer harming themselves or at least not anywhere near as much, it’s up to us to pick up the ball. We now should be able to fill in the blanks and present them with the next step which would of course be getting off the Suboxone. A reversal. Now providing the option where the mind becomes strong enough to control the body and no longer the body controlling the mind.

  3. Thanks for this. I think your cautions and concerns with medication treatment (MAT) are correct. There is no developed medical protocol for tapering off of Suboxone. It was the second most abused drug in 2013. Here is a great article on tapering off of Suboxone by Guinevere of Guinevere Gets Sober, another recovery blog: http://guineveregetssober.com/?s=Suboxone%27. There is no question that coming off of methadone or buprenorphine is more difficult than coming off of heroin.

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AfterParty Magazine is the editorial division of RehabReviews.com. It showcases writers in recovery, some of whom choose to remain anonymous. Other stories by AfterParty Magazine are the collective effort of the AfterParty staff.