We have had a lot of talk in our Fight Addiction Now community about getting off of heroin, prescription painkillers like OxyContin, and even opioid maintenance drugs like Suboxone and methadone. There is a lot of enthusiasm for this topic, and it is definitely a hot topic amongst those who have successfully gotten sober, are working towards their sobriety, and even those that are addicted and looking to find their options for heroin addiction treatment.
There has also been a debate on the subject of using drugs to get of drugs – specifically, using opioid drugs to get off opioids. There is so much to bring up about this topic that we wanted to outline what it truly means to use medications to quit heroin and other drugs, and have a real talk about this controversial subject to continue the conversation in the Fight Addiction Now community.
Let’s start with the most common argument against using medications and substances in people that have an addiction to medications and substances.
Isn’t Medication Assisted Treatment (MAT) Just Using Drugs to Get off Drugs?
Medication Assisted Treatment is a common practice in the United States and is quickly being recognized as the preferred method of treatment for addiction treatment. Still, many aren’t convinced that this form of treatment and our community has brought up a lot of very good points on the subject – both for and against this method.
What is Medication Assisted Treatment (MAT)?
Medication Assisted Treatment is simply a treatment that combines medication therapy and behavioral therapy (addiction counseling, therapy, holistic treatment and therapies, cognitive behavioral therapy, psychodrama therapy, and any combination of therapies to treat the behavioral aspects of an addiction to drugs and alcohol).
The reason it is a preferred method of treatment is because of its harm reduction potential. That just means that a person using this therapy is much less likely to harm themselves than using other therapies. This harm from continual relapses, overdose, death, or the negative health effects that can arise from the continued use of illicit drugs like heroin bought from the street. Essentially, you are less likely to cause yourself any more harm than is already done, by using the medication and dosages given by a medical professional.
What Drugs Are Used For Opioid Medication Assisted Treatment (MAT)?
The types of medications used in MAT seem to be causing the biggest stir in our community and in the public eye in general. Currently, the only three types of medications allowed by the FDA for opioid medication-assisted treatment are:
Are these drugs perfect? No, far from it… but they have been deemed safe to use for both opioid maintenance and for detoxing/tapering from opioid addiction. Methadone and Buprenorphine are both addictive substances – and some would argue that they are more addictive than heroin and prescription painkillers that contain opioids. The combination of the negative side effects of the drugs and their addictive properties is one of the primary reasons people argue against their use in treating addiction.
How Long Should You Take Methadone/Buprenorphine?
The length of time that a person should be taking methadone or buprenorphine drugs like Suboxone is where a grey area is created in the use of these drugs. There is a huge difference in using Suboxone on a taper schedule for 30 days to get completely off drugs, and taking high dosages of Suboxone for months or years, with no plan to taper down or quit them completely.
Long Term Opioid Use and Opioid Maintenance
Anyone who has taken drugs recreationally – especially prescription drugs – knows that there is a “right” way to take drugs, and a “wrong” way. All prescription drugs were created to treat the symptoms of various medical maladies, from pain to anxiety to regulating blood pressure. When you don’t medically need the drugs to address symptoms, you are not supposed to take them.
For those suffering from chronic pain, there is a need to take medications to address the symptoms of pain for longer periods of time. The likelihood of dependence and addiction is high, but it is medically decided that treating the symptoms and reducing pain is more of an immediate concern than the risk of addiction is.
Long-term use of prescription painkillers is not recommended for everyone, but in some cases may the best solution for treating pain and symptoms in patients.
Following this same line of thinking, some opioid addiction programs will utilize opioid maintenance therapy in a long-term program. These types of programs give patients monitored dosages of opioid drugs on a daily, weekly or monthly schedule. Also within the programs, the dosages are not tapered down, and the goal is to stay on the medication long-term, not to quit the medication and opioids completely.
This type of program is not for all people who have an addiction to opioids and is usually (or should be) reserved only for those cases where it is medically decided that the long-term use of the drugs is more beneficial to the wellbeing of the patient than getting them off drugs is. People who suffer from chronic relapse and risk death from injecting illicit drugs that could cause overdose and death are good candidates for this type of treatment.
Long-term use of opioid medications like buprenorphine/Suboxone and methadone is not recommended for everyone, but in some cases may the best solution for keeping an individual who is addicted to opioids alive.
The Possible Dangers of Long-Term Opioid Maintenance
There are many dangers to using any drug long-term, and even the drugs used in opioid maintenance have their dangers. One of the biggest concerns/dangers members of our Fight Addiction Now community have pointed out is that some “addiction treatment programs” (if you can call them that) are all too quick to get individuals that don’t fit the criteria for long-term opioid maintenance on a long-term opioid maintenance plan.
Yes, there are suboxone and methadone clinics all over the country that either don’t assess the needs of individuals properly or take a predatory stance towards addicts and try to get opioid addicts into long-term Suboxone and methadone use. Some of these clinics take it a reckless step further and will start opioid addicts on dangerously high dosages when they are not needed.
These dosages could even be so high that they pass the threshold for safe detox dosages – meaning that the dosages you are on is so high that most detox treatment programs will refuse to detox you due to medical concerns. In these cases, attempting to quit is dangerous and could take months or years to safely taper down, and the clinic has made a customer for life.
The danger of disreputable Suboxone and methadone clinics getting you hooked for life is very real. Some of these programs even call themselves addiction treatment programs or offer a “Cure for Heroin Addiction.”
Those that are addicted to heroin and other opioids should be careful and do plenty of research into a program before starting treatment. In this sense, our community members and the public is right in sharing a word of warning about programs that utilize opioid replacement drugs. However, not all programs that utilize these drugs have this unsavory intent.
Programs That Safely Use Medication Assisted Treatment, Suboxone, and Buprenorphine
Now that we have addressed the dangers of opioid replacement drugs, let’s focus on the benefits of using medication assisted treatment, and how “using drugs to get off drugs” is not always a bad thing.
The Dangers of Opioid Withdrawal and Quitting Heroin/Painkillers “Cold Turkey”
There are certain drugs that have such a strong grip on their users that even quitting them abruptly could lead to serious physical harm and death. Alcoholics and those with a strong physical addiction and dependence to alcohol CANNOT quit “cold turkey.” The withdrawal symptoms – specifically the DTs (delirium tremens) – can be so severe that organs will shut down, a patient can experience seizures, and the threat of death is very real.
Opioids like heroin, OxyContin, fentanyl, and other prescription drugs also prevent dangerous withdrawal symptoms. While not as dangerous and immediately life-threatening as with alcohol, the symptoms of opioid withdrawal are strong enough and painful enough to convince a user that being addicted isn’t as painful as the withdrawals.
Without medication to help ease these symptoms, the addict might never be able to quit drugs completely and risks the chance of dying as an addict.
When faced with the 2 choices of: 1.) detoxing from opioids painfully and excruciatingly without medication, or 2.) making the detox process a little easier by using drugs to step down the intensity slowly and safely – medication-assisted detox utilizing (MAT) and medication-assisted treatment drugs offers a safer and common sense approach.
Getting Help for Opioid and Heroin Addiction is the Best Way to Recover
We have laid out the controversies and concerns about treating an addiction to drugs with drugs, though we have only scratched the surface. We expect that this outline will give us much more to talk about (we haven’t even brought up the possibility of using kratom and non-FDA approved drugs into the mix). However, this gives some common ground to further the conversation.
As one of the members of our community brought up, “it doesn’t matter what method you used to get off heroin, so long as you got off and stayed off.” To an extent this is true, the ultimate goal of anyone who has struggled with addiction and substance abuse is to find a way to get through life without feeling beaten down and broken. To find that life can be worth living again… to find a way to cope with the mistakes we’ve made and to simply get more out of the time we have on this earth.
As long has you have a clear picture of your goals, have a commitment to your sobriety, and are prepared to work for what you want, you can recover from the addiction that has held you down for too long.