For decades, methadone has been used as a front-line treatment for heroin addiction, as the drug can soothe symptoms of heroin withdrawal and make a relapse to heroin much less likely. Recovering heroin addicts rarely, if ever, have free access to this powerful drug. Instead, they are given one dose at a time in specialized clinics under strict supervision. The potential for abuse under this scheme is remarkably low, as it is almost impossible for people to hoard the drug and take it in large amounts. As a result, the addiction rates to heroin have remained historically low. Much of that changed in the 1990s, according to the U.S. Centers for Disease Control and Prevention. During that time, doctors began looking for inexpensive drugs that could control chronic pain. Methadone seemed to fit the bill quite nicely, and doctors began prescribing the drug to patients, providing them with full prescriptions to methadone that they could take at home. Addictions quickly followed.
Living with a methadone addiction can be disastrous, and some people who have these addictions incorrectly believe that there are no treatments that could help them. After all, they reason, they are addicted to a drug used for addiction. Isn’t this the end of the road? Thankfully, experts say that there are effective treatments for methadone addiction, and that all people who have these addictions can get the help they’ll need in order to get better. Read on to find out more about what these treatments entail.
Additional Medications May Be Required
Methadone is an effective treatment for heroin addiction because it attaches to the same receptors used by heroin. However, this trait might make methadone addictions hard to overcome without medication help. Just as heroin addicts face physical symptoms of withdrawal when they attempt to stop using heroin, methadone addicts might also feel discomfort during their withdrawal process, and they might face cravings for drugs for weeks or even months. If these symptoms are not treated, a relapse to drug use might quickly follow.
Some addiction programs might use controlled doses of methadone to help their addicts improve. These programs might enroll their participants in structured addiction programs in which they’re only given medication on a structured dosing schedule at a specific facility. They’re given only enough methadone to quell their physical symptoms of withdrawal, and they’re never given drugs to take at home. It might sound odd to treat a methadone addiction with methadone, but the technique can be effective, as long as patients are monitored extremely closely.
Some addiction programs transition their methadone patients to another medication known as buprenorphine. This drug also works on opiate receptors, just like heroin and methadone, but it doesn’t cause any symptoms of euphoria at all. Instead, the drug simply reduces symptoms of discomfort and cravings caused by withdrawal. This drug is sometimes combined with the agonist naloxone, which blocks the effects of buprenorphine if a user attempts to abuse the drug. According to the National Institutes of Health, this ingredient allows doctors to prescribe the drug and allow patients to take the drug at home. Unlike methadone, which patients might willingly abuse at home, buprenorphine really can’t be abused in the same way.
While some people might need to stay on replacement therapies like this for the rest of their lives, as a removal of the therapy triggers strong urges that could lead to relapse, some people use medications only for a short period of time, allowing their bodies to adjust.
When they begin to feel stronger, they might work with their doctors to:
- Slowly taper the dose
- Replace methadone replacement with buprenorphine replacement
- Increase the amount of time between doses
- Stop using any medication at all
Maintaining Sobriety With Medication
Even though a person might be convinced that he/she will never use again, the person’s body might call out for methadone at unexpected times, making a relapse possible. There is one more medication doctors can use to make this relapse just a bit less likely. The medication naloxone, mentioned above, is also provided as a standalone drug. People who take this drug effectively build up armor against the effects of opiates like heroin or methadone. If people take naloxone and then try to take these opiate drugs, the opiates simply will not work. Their effects are totally blocked by the naloxone.
Some therapists use a technique called contingency management to ensure that their patients stick with naloxone therapy. Here, therapists provide prizes or other rewards to people who comply with the treatment. This technique can be an effective way to motivate people to participate in their care programs and maintain their medication use. For example, a study of the method published in the journal Drug and Alcohol Dependence found that those who were provided with this therapy stayed in treatment for significantly longer periods of time, and took more doses of naltrexone as a result, when compared to people who did not get this form of therapy. This technique really can motivate some people to stay involved in care. Therapists can also ensure compliance by using another form of naloxone. This injectable drug lasts for days at a time, so participants aren’t required to take pills at home. This might be a good form of therapy for people who can’t be trusted to follow their treatment protocols while at home.
Moving Past Medications
While medications can be of vital importance in the treatment of a methadone addiction, drugs alone aren’t enough to help people to truly heal. Therapy is a vital part of the process, and skipping those therapy sessions could be disastrous for overall health. For example, a study in the Journal of Addictions Nursing compared treatment success rates in people who received methadone treatment alone, and those who received therapy in addition to methadone. Researchers found that the more therapy people received, the more likely it was that they would get well. In fact, the differences between the people who got low levels of care and the people who got the highest levels of care were deemed “significant.” For people in recovery, therapy can make a world of difference.
The therapy choices available are staggering, including:
- Cognitive behavioral therapy
- Family therapy
- Group therapy
- Individual therapy
The type of therapy provided is often dependent on the issues the addict is facing, and the addict’s individual experience with addiction. People who have underlying mental illnesses, for example, might need therapies that help them to process that damage and learn to control their conditions without resorting to drug use. People who have long family histories of addiction might need to process childhood anger, so they can stop numbing their pain with drugs. Therapists work hard to understand their patients on an emotional level, so they can develop treatment programs that will deal with the issues at the core of the addiction.
Thousands of studies have demonstrated the effectiveness of therapy in helping people to overcome addictions to opiates like methadone. In one such study, researchers looked at married or cohabitating men who abused substances and were receiving care. One group of men received couples therapy, while another group did not. According to the results, published in the journal Behavior Therapy, men who received couples therapy had happier relationship scores than the men who did not receive the therapy, but they also had lower drug use scores. Improving their relationships improved their addictions too. Therapy really can make a difference.
Dealing With Pain
Since so many people transition to methadone addiction as they attempt to deal with chronic pain, addiction treatment programs for methadone addiction also must address chronic pain in those they treat. Sometimes, people can learn alternate methods of pain control in their rehabilitation programs. These people might learn to use yoga to stretch tight and painful muscles, or they might try acupuncture or another Eastern treatment that doesn’t involve drugs.
There are some cases of chronic pain that simply won’t respond to alternative medicine, however, and people in chronic pain might be at a very high risk of addiction relapse as they desperately look for ways to reduce their discomfort. Doctors might help these patients by using non-narcotic pain medications such as NSAIDs. But people who can’t find relief with these drugs might still be provided with narcotics on a strictly controlled schedule. An article in the Clinical Journal of Pain suggests that addicted people in recovery can use narcotic painkillers as long as they have medication agreements with their doctors, and they take the drugs exactly as they are prescribed. Doctors might also require these patients to go through drug screening tests on a regular basis, to ensure that they’re not abusing the drugs they have been given. This can be an effective way to control pain while remaining mindful of the risk of addiction.
People who have strong family connections and a home environment that isn’t conducive to drug use and abuse might be able to receive methadone addiction treatment on an outpatient basis, but people who know they will never comply with care unless they are closely monitored might do well to enroll in inpatient care. By living in a controlled environment, they can ensure that they’ll have time to take the lessons to heart and build up resilience before they return to the temptations at home. If you’d like to know more about this type of care, and find out what it’s like to live in a residential facility for addiction care, please contact us at Axis. We’re happy to answer any questions you might have.