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What’s Your View on the Use of Methadone, Suboxone and Vivitrol in Substance Use Disorder Treatment?

By Deni Carise, PhD

Medication-assisted treatment (MAT) continues to play an instrumental role during our country’s opioid crisis. MAT services can provide an effective, comprehensive, individually tailored program of medication and behavioral therapy. The medications used help patients with substance use disorder by significantly decreasing cravings for opioids or alcohol and blocking the euphoric effects. They provide harm reduction benefits for the public by decreasing needle use, criminal activities, and HIV/HEP-C transmission. Importantly, they also increase patients’ ability to gain and maintain employment, and improve birth outcomes among women who have substance use disorders and are pregnant.

There are now three primary options for the use of medications in substance use disorder treatment: methadone, buprenorphine (most often Suboxone/Subutex) and naltrexone (brand name Vivitrol). Although they all provide support in helping patients, each has different indications, uses, goals, benefits, and side effects. But what are they?

On Friday, August 16th, I will be presenting at the National Conference on Addiction Disorders (NCAD) East, the premier provider of continuing education for addiction, behavioral, and mental health professionals. My co-presenter is Charles O’Brien, MD, PhD, Vice Chair of Psychiatry at the Perelman School of Medicine at the University of Pennsylvania. Together we will describe the development, mechanisms of action, intended uses, and “real world” experience implementing these three primary options in medication-assisted treatment. Special focus will be given to the medication’s role in diminishing cravings for drugs and alcohol, reducing the harms associated with drug use, and their risk/benefit profile.

According to SAMHSA, there has been slow adoption of these evidence-based treatment options for alcohol and opioid dependence, partly due to misconceptions about whether they are just a substitution of one drug for another. Discrimination against MAT patients is also a factor, despite state and federal laws clearly prohibiting it. Other factors include lack of physician training or prescription limits, as well as negative opinions toward MAT in the recovery community.

What’s your view?

Join the over 1,100 professionals at NCAD East in Baltimore, MD, and don’t miss our presentation on 8/16 from 10:15-11:30 am. Or stop by the Recovery Centers of America booth (#608) to learn more about the range of available treatment options. RCA is a proud sponsor of this event and will have more than a dozen of our professional staff attending. We look forward to seeing you there!

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