Support for Medication-Assisted Treatment (MAT) has continued to grow in recent years as the opioid epidemic in America has put a mounting strain on the country. While the numbers of overdoses and opioid-related deaths have steadily climbed to devastating heights there has been more effort to explore treatment options. A better understanding of the medical and mental health aspects of addiction has become a priority. Stigma has slowly begun to carry less weight while advocates push for more effective and supportive routes to care for recovering addicts. One thing people have turned to heavily is medications like Suboxone of Methadone in attempts to steer away from more illicit and dangerous substances like heroin or fentanyl.
The application of medication in treatment can be very useful. It is a strategy that can help with the preservation of life by helping people stay off more unpredictable and life-threatening substances. However, some would say that if used for long-term this form of treatment is still relying on the idea of substitution. Often times these drugs have their own very harsh withdrawal symptoms, especially with extended use.
Taking a look at the more popular drugs used for medication-assisted treatment, one may ask- can you quit medication-assisted treatment with no withdrawals?
Understanding Medication-Assisted Treatment
Medication Assisted Treatment is the use of anti-craving medications to try and help address issues related to drug dependence, withdrawal, and relapse. The more common medications used in MAT include:
But MAT is also utilized alongside comprehensive therapy and other forms of support. Experts and advocates for addiction recovery, including the Substance Abuse and Mental Health Services Administration (SAMHSA), insist that maintenance medications alone are not sufficient enough treatment.
Advocates for medication-assisted treatment will compare MAT to someone taking medication for diabetes or asthma, with the belief that maintenance drugs are an essential part of staying healthy. However, others in the world of addiction recovery still believe it is possible to be healthy in recovery without the prolonged use of powerful medications.
The truth is the answer may not be the same for everybody. Different treatments may be more useful for different people. No one should be ashamed of the method they use to get help. But we also want to look at how some drugs used in medication-assisted treatment might make things more complicated for certain people.
Suboxone
Looking at the most popular maintenance drugs for opioid addiction, of course, we find Suboxone. To better understand Suboxone withdrawals, we first have to know what it is. This popular brand name is used to identify a prescription medication that contains active ingredients:
- Buprenorphine- a narcotic opioid medication
- Naloxone– an opioid blocker that impedes the effect of opioid medications
This medication functions as a partial opioid agonist and diminishes cravings as well as prevents other opioids from reacting to the brain’s opioid receptors. Taken in low doses for short periods of time, the drug can be helpful in curbing opioid withdrawal symptoms while tapering off without too many residual effects.
The tricky part comes when someone uses Suboxone for an extended amount of time as a replacement for heroin or other opioids.
Sometimes this can lead to its own form of recreational use and physical dependence. Even the U.S. Drug Enforcement Administration reports that Suboxone is commonly susceptible to abuse. It is still a powerful drug.
Suboxone Withdrawal Symptoms
While Suboxone and other maintenance drugs may be a preferred tactic for going ‘cold turkey’ off of heroin or other opioids, the drug itself still has the power to cause its own set of withdrawal symptoms. These symptoms can include:
- Irritability or agitation
- Anxiety
- Difficulty sleeping
- Profuse sweating
- Tearing
- Runny nose
- Frequent yawning
- Stomach pain or cramping
- Diarrhea
- Dilated pupils
- Nausea and vomiting
- Confusion
- Changes in mood
Not to mention precipitated withdrawal, when the ingredients in this medication can actually induce the onset of unpleasant symptoms rapidly, if not immediately, for someone actively engaged in opioid use.
Methadone
Methadone is a long-acting opioid medication utilized since the 1970s to try and help people get off of heroin. It is typically used today under strict medical supervision because the drug is very potent and has a high risk of addiction. In fact, a 2012 National Survey on Drug Use and Health found that approximately 2.46 million people reported to using methadone for a non-prescribed purpose at least once.
According to another study, in 2009 methadone was responsible for 1 out of every 3 opioid overdose deaths.
Because of the risks, a gradual taper should be utilized to wean someone off of methadone. Often times doctors will prescribe another detox medication to help with this process, with the tapering to be done under medical supervision.
Methadone Withdrawal
But as with trying to quit heroin or other powerful opioids ‘cold turkey’, trying to abruptly discontinue methadone can bring on intense withdrawal. This includes physical and psychological symptoms such as:
- Agitation
- Anxiety
- Depression
- Insomnia
- Runny nose
- Tearing or watery eyes
- Muscle aches
- Joint pain
- Sweating
- Nausea
- Abdominal cramps
- Diarrhea
- Vomiting
- Shivering
- Trembling
Many of these symptoms are similar to the symptoms of withdrawing from heroin or other opioids. So in a sense, this drug can create similar withdrawal symptoms as the drugs it is supposed to be used to treat.
Quitting Medication Assisted Treatment
Is it possible to quit medication-assisted treatment- yes, there are always other options for getting comprehensive care and lasting recovery without the prolonged use of these medications. Even relapse prevention is possible without relying on medications to fight cravings.
Can you quit medication-assisted treatment with no withdrawals? Well, that may be a process. It depends on a number of factors, such as the specific maintenance medication and the length of time using it. For example, someone who has been using methadone for years could probably have a much harder time getting off methadone than someone who used another medication for a month or so to help get off opioids.
Safety is crucial when deciding to quit MAT. Quitting medication-assisted treatment without a taper or other forms of medication can cause intense withdrawals. It is not suggested that someone try to quit MAT ‘cold turkey’ or without consulting a doctor for help with changing the dosage and slowly tapering off the drugs.
Again, just because it isn’t heroin or fentanyl doesn’t make it harmless.
MAT or Detox?
Medication-assisted treatment holds a lot of value, but the question becomes whether or not it is the kind of sustainable solution you want. Recovery isn’t one-size-fits-all. Medication-assisted treatment can be helpful in saving someone’s life who cannot stop using drugs. But is it something that will completely eliminate cravings and withdrawals, or will it just postpone these symptoms?
Remember, these are still powerful narcotic drugs that have a high risk for abuse. Some people end up using medication maintenance for life. Others will use it for a short period of time, with a detox period afterward. Either way, it is your choice; how long do you want to rely on substances, and to what extent?
Other models believe in providing holistic treatment and personalized therapy after a detox period, helping to reduce and remove chemical dependence and build a foundation for personal recovery.
Using medication to help with the painful and often overwhelming symptoms of withdrawal from opioids and other drugs can be essential to a smooth and healthy transition. In fact, with a safe medical detox, each individual is given an initial assessment to see what medications will be helpful in making this phase of treatment comfortable and safe. This can include medications for anxiety, mood disorders, physical pains and various other side-effects of substance abuse.
And when it comes to some of these medications, it can sometimes be necessary to continue using them.
The biggest difference is whether narcotic maintenance medications like Suboxone or methadone become a long-term prerequisite to recovery, or if they are used to help someone who is sick get better so that the real healing can happen.
