By Katie Miller, PharmD, Principal, Clinical Product Development
Health and Human Services Secretary Tom Price’s recent comments asserting that medication-assisted treatment (MAT) involves substituting one addiction for another for the treatment of opioid use disorder (OUD) have received significant backlash from the healthcare community, prompting hundreds of healthcare and research professionals to sign a letter urging him to reconsider his statements. This view, shared by others, undermines the value MAT brings patients and highlights common misconceptions about addiction and treatment. From the Substance Abuse and Mental Health Services Administration:
A common misconception associated with MAT is that it substitutes one drug for another. Instead, these medications relieve the withdrawal symptoms and psychological cravings that cause chemical imbalances in the body. MAT programs provide a safe and controlled level of medication to overcome the use of an abused opioid.1
MAT also incorporates numerous components outside of medication administration to help patients integrate back into a stable, healthy lifestyle and address psychosocial or behavioral health conditions. A former president of the American Society of Addiction Medicine stated, “MAT in addiction treatment is not required for everyone, but used in conjunction with 12-step programs and other biopsychosocial interventions, for those that need it, has shown to be invaluable in appropriate cases.”2
Addiction negatively impacts key components of function in a person’s life and is often associated with a high degree of instability. MAT allows patients to regain stability in daily activities, employment, relationships, and finances. MAT can also protect against the acquisition and spread of infectious diseases associated with intravenous drug use and risky behaviors, decrease overdose deaths, and decrease a person’s use of other illicit drugs or non-prescribed opioids.3-4
OUD is a “chronic, relapsing disease” which requires adaptable, broad treatment options that can be tailored to patient-specific needs, which change over time.5 Similar to other chronic diseases, OUD patients demonstrate different levels of motivation for recovery, varying access to resources, and ever-changing life circumstances that may require different approaches depending on the phase of life. We oversimplify the plethora of challenges associated with treatment of substance use disorder by limiting treatment options based on perceived or cultural acceptability.
axialHealthcare’s solutions address challenges around opioid use from many angles – from preventing overprescribing at the initial point-of-care, to limiting the risks for OUD in patients receiving opioids for chronic pain, to using behavioral health coaches and mobile technology to engage patients in their treatment process and manage chronic health conditions, to the newest initiatives centered around individuals seeking and sustaining recovery from OUD and providing point-of-care based resources to practitioners caring for patients with OUD. Like all of axial’s capabilities, the OUD initiatives utilize the latest evidence-based best practices to provide safe, effective and individualized treatment for patients, which includes access to MAT when indicated.
It is going to take open-mindedness, creativity, research and innovation to make progress in the area of addiction treatment. Perhaps it’s worth remembering that we are all aiming to improve patient care, decrease harm associated with addiction, limit the public health implications of substance use disorder, and protect individuals and communities from the negative sequelae associated with untreated substance use disorders. There is no single solution for addiction. Complex diseases require multifaceted approaches and solutions.
References:
- “Medication and counseling treatment.” Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medication-assisted-treatment/treatment. Accessed May 22, 2017.
- “Twelve step recovery and medication assisted therapies.” American Society of Addiction Medicine. http://www.asam.org/magazine/article/2014/06/12/twelve-step-recovery-and-medication-assisted-therapies. Accessed May 22, 2017.
- Volkow, Nora D, et al. “Medication-Assisted Therapies–Tackling the Opioid-Overdose Epidemic.” The New England Journal of Medicine. May 2014; 370(22): 2063-2066.
- Connery H. Medication-assisted treatment of opioid use disorder: review of the evidence and future directions. Harvard Review Of Psychiatry. March 2015; 23(2): 63-75.
- Kampman K, Jarvis M. American Society of Addiction Medicine (ASAM) National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use. Journal Of Addiction Medicine [serial online]. September 2015; 9(5): 358-367.