Medication Assisted Treatment: Solution or New Epidemic

Student: Benjamin Valdez

Mentor: Christine Henderson

Abstract

The opioid epidemic is rapidly impacting individuals across the nation. The rates of overdose have increased significantly, resulting in healthcare providers, government workers, law enforcement, and other individuals in professional standing to take action. The illegal use of narcotics has caused devastation throughout communities across the United States, which has resulted in policies and procedures being implemented as possible solutions to the opiate epidemic. A solution that many are currently advocating for and encouraging the addicted population to pursue is medication-assisted treatment (MAT) services and the encouragement of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT) of 2018 which allows physical health providers the ability to prescribe medication for MAT services.
Unfortunately, there is a disconnect between addiction treatment providers and the medical community regarding MAT services, which cause oversight to new problems emerging with the addicted population that include dependence on the MAT services medication and inconsistent compliance standards. By implementing a standard protocol for providers to follow with the encouragement/requirement of alternative treatment solutions to address the behavioral components, the likelihood, an individual will be successful at maintaining abstinence increases.

Presentation

2 thoughts on “Medication Assisted Treatment: Solution or New Epidemic”

  1. I think this is a very important and relevant topic. You mention health care providers needing to treat the whole person and I fully agree. How would you create set standards of care to ensure healthcare providers are treating the whole person instead of taking an “easy” approach and prescribing medication to just treat symptoms? Which is what I believe is current;y happening and contributing to today’s opioid crises.

    1. As addiction impacts the whole person (physical, emotional, behavioral, spiritual), all of these components must be addressed to increase the optimal chance of success. My suggestion for compliance standards would need to be a collaborative effort between SUD providers and physical health providers prescribing medication for MAT services. Important components need to include the following:
      1. Dose of Medication – How long, how frequent, and how many times a day.
      2. Behavioral – Follow through with behavioral health treatment/recommendations for levels of care (residential, intensive outpatient, relapse prevention). Status reports concerning compliance with treatment program standards (such as group involvement, individualized service plan completions, integration of recovery based skills into daily living) must be verified in conjunction with the medication that is taken.
      3. Environment – Is the individual living in an abstinence based environment? Do they have active involvement in recovery support groups? Are they employed/able to support themselves?

      Medication for MAT services addresses the physical component of addiction which is undoubtedly helpful. That being said, the other aspects of addiction need to have equal focus.

      As an example, the current state of the world during this pandemic is resulting in loss of jobs and requiring social distancing. If the addicted population is relying solely on Medication to manage their addiction and are unable to pay for that medication, the addicted population needs to have alternative coping mechanisms and preventative measures in place that don’t rely on medication specifically to be effective. It is not uncommon to see individuals taking the medication achieve abstinence until they taper off the medication. This is largely due to the absence of recovery based skills/coping mechanisms that have not been fostered in conjunction with the medication.

      An analogy that is often used in the treatment of substance use disorder stems from the disease of diabetes. The medication (insulin or other forms of medication) is meant to address the physical complications surrounding the disease while the behavior (appropriate diet and exercise) enhances the impact of the medication to increase the quality of life for the patient. The same components are found with MAT services and the addicted population. Should the addicted population only take medication without changing behavior, the chances at an increased quality of life or successful abstinence after discontinuing the medication is reduced. Should behavioral, emotional, spiritual, and environment aspects of the whole person change in conjunction with the use of MAT services, the true benefits of this program will emerge.

      The addicted population requires accountability from multiple individuals to increase chances of success. By implementing stricter compliance standards that address multiple aspects of the addicted population, there will be enhanced effects of medication to treat opiate addiction while educating the individual how to live a life in abstinence. With MAT services, the goal is to assist the individual with physical health provider intervention to arrest their disease. Unfortunately, some individuals stay on the medication for a substantial amount of time which causes dependence on a different substance instead of true abstinence.

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