The use of FDA-approved medications in combination with counseling and behavioral therapies is widely considered to be an effective solution to our nation’s current opioid crisis. Medication-assisted treatment (MAT) successfully decreases opioid use, opioid-related overdose deaths, criminal activity, and infectious disease transmission, according to the National Institute on Drug Abuse (NIDA). Plus, it increases social functioning and retention in treatment.
“MAT is unequivocally life-saving,” says Heidi Ginter, MD, FASAM, an expert with almost 20 years of experience with medication-assisted treatments and Recovery Centers of America’s new Chief Medical Officer.
Nevertheless, MAT continues to face opposition. “MAT does not substitute one drug for another,” explains Dr. Ginter. “Using medication in conjunction with behavioral change is the standard of care to treat many chronic illnesses like asthma, type 2 diabetes and hypertension. Substance use disorders are no different.”
This type of treatment’s medications restore balance to the brain circuits affected by addiction, allowing the patient’s brain to heal while working toward recovery.
“Similarly, a patient with type 2 diabetes may use insulin to help control blood sugar levels in addition to managing their diet,” says Dr. Ginter. “Substance use disorders and diabetes are both chronic diseases that require attention to maintain control over many years and often one’s lifetime.”
“There is a stigma that persists that medication for addiction is somehow ‘enabling’ or demonstrating ‘weakness’ compared to a purely behavioral approach such as the 12 Steps,” says Dr. Ginter. “In reality, both can be successful. Treatment is not one-size-fits-all, just as our patients are not. MAT is really the equivalent of the methods people have used to manage other chronic illnesses for decades.”
Chronic conditions rely on patients taking an active role in self-management of their health with adherence to prescribed measures from a medical provider according to Dr. Ginter. Patients manage their condition well at times and other times they need additional support to stay on track.
“Most people would be appalled if a medical provider terminated a patient whose diabetes was not in control. However, many believe that a patient with a substance use disorder should be terminated from treatment if they relapse. On the contrary, relapse demonstrates active disease which needs continuous and augmented support and options for regaining control,” she says.
MAT, including the use of buprenorphine, methadone, and extended release naltrexone, is an option that requires the patient to re-engage for regular dosing and counseling sessions. In addition, treatment of opioid-dependent pregnant women with methadone or buprenorphine improves outcomes for their babies.
“My medical career began in a setting where I worked frequently with underserved populations and women who were pregnant and struggling with addiction,” says Dr. Ginter. “I developed a kinship with these women and really enjoyed caring for them through their pregnancy — with MAT — so they could maintain sobriety and parent their children. I’ve seen how MAT can profoundly affect lives and I will do all I can to help erase its stigma.”