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.
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
- Difficulty sleeping
- Profuse sweating
- Runny nose
- Frequent yawning
- Stomach pain or cramping
- Dilated pupils
- Nausea and vomiting
- 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 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.
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:
- Runny nose
- Tearing or watery eyes
- Muscle aches
- Joint pain
- Abdominal cramps
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.
Palm Healthcare Company believes in providing a safe medical detox to allow for a comfortable and healthy transition from active drug or alcohol use. Our facilities utilize an experienced and professional medical staff who help to monitor each individual’s progress and provide effective medical support for lasting recovery. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now. We want to help.
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The Big Pharma industry is still in the hot seat, and this week another lawmaker is adding a new name to the roster of drug makers to be investigated for shady marketing practices. Alkermes, the company behind the opioid treatment implant Vivitrol, is now being investigated for how they market their product.
Background on Vivitrol
Vivitrol is another name given to the generic drug Naltrexone. Originally approved by the U.S. Food and Drug Administration (FDA) for the treatment of alcohol dependence in 1994, Naltrexone eventually became approved for the treatment of opioid dependence. The medications primary use appears to be blocking the opiate receptors in the brain. It’s intended so that someone using heroin or other opiate-based drugs cannot experience the drugs high.
The Vivitrol shot is made by Boston-based biotech Alkermes. This medication stood out from other Naltrexone medications because Vivitrol is an injection given every 4 weeks with a monthly doctor visit. It is time released for longer lasting relief, instead of being a pill taken once a day.
Supposedly Vivitrol is intended to further help by reducing cravings for opioids. However, Naltrexone and Vivitrol have been refuted by many for having any notable effect on opioid cravings.
Enter Senator Harris
Kamala Harris is a Democratic California Senator who has announced she will be part of launching a new investigation into the sales and marketing practices of the makers of Vivitrol. According to the senator, Alkermes allegedly worked to increase sales of their opioid treatment medication through two questionable strategies:
“Aggressively” marketing Vivitrol to officials in the criminal justice system
Senator Harris says that Alkermes pushes for judges and lawmakers to use their product. The company even provided free samples, which resulted in Vivitrol being actively implemented in 450 treatment programs across 39 states.
Lobbying efforts by federal and state lawmakers
In her statement, Harris also alleges that the company has spent millions of dollars in direct appeals to government officials. Meanwhile, they were contributing to numerous congressional campaigns.
Due to the drug companies marketing, Vivitrol raked in well over $69 million dollars in the third quarter of 2017.
In her statement Senator Harris says,
“We are at the height of a crisis, and companies are taking advantage of pain in order to profit”
“We must hold these companies accountable for their deliberate actions that magnify the opioid epidemic and drive up the cost of drugs for Americans.”
The senator even quoted the chief of addiction medicine at Stanford University School of Medicine, Dr. Anna Lembke, who said,
“Alkermes has taken unethical drug promotion to new depths by enlisting judges, law enforcement personnel, and legislators to favor Vivitrol over proven treatments. Alkermes’ actions undermine public health.”
Which seems like some pretty strong words. In the midst of the opioid crisis, it might be fair to say we should use every resource we can get. However, the Big Pharma enterprises still need to be put in check when it comes to overlooking more effective treatments.
In fact, a 2011 review of studies suggested that Naltrexone was not significantly superior to placebo, and the authors believed there was no sufficient evidence to support Naltrexone therapy for opioid dependence.
One reason Senator Harris seems to have Vivitrol in the crosshairs seems to be that the pharmaceutical company made a habit out of promoting Vivitrol as a more effective treatment than other maintenance drugs, such as Suboxone or Methadone, even though there is no substantive data to support this claim.
As part of the investigation, Harris contacted Richard Pops, the Alkermes Chairman, requesting the company provide data and communication. At the moment Alkermes is disputing the allegations. Senator Harris appears to be calling their bluff, as she was requested that Alkermes submit:
Alkermes has also been asked to turn over any materials provided to participants or speakers for Alkermes since 2010. They’re being asked to disclose amounts paid to the company by various associations, including:
American Society of Addiction Medicine
National Institute on Drug Abuse (NIDA)
Partnership for Drug-Free Kids
Any studies presented to these groups are also to be turned in.
In their own statement, Alkermes states they are “focused on ensuring that patients, healthcare professionals, and criminal justice officials are educated on Vivitrol, and believes that patients should have access to all medications.”
There is no telling whether or not this investigation is going to turn into a witch hunt or if it will blow the lid off of even more bad behavior from Big Pharma. While other drug companies that can be connected to the opioid crisis are already facing lawsuits and others even criminal cases for racketeering and fraud, the Vivitrol producers might find themselves on the chopping block sooner rather than later.
There is already much disagreement about whether or not the Vivitrol treatment is really effective in the first place. Some say the medication helped save their life. Many others have horror stories of uncomfortable side-effects made worse by cravings. Either way, pharmaceutical companies still need to be held accountable for their marketing methods, especially when they seem a little suspect.
For now, this is all a request. Only Republican Senator Ron Johnson has the power to issue subpoenas on behalf of the Homeland and Governmental Affairs Committee.
When talking about the most effective treatment programs for addiction, we should also remember that maintenance drugs like Suboxone, Vivitrol and others are not exactly a solution. While they can be effective in keeping people alive and helping to overcome their sickness, the real healing does not come from magic pills or implants. The real transformation comes with developing the understand and the tools to take care of yourself. If you or someone you love is struggling, please call toll-free now.
CALL NOW 1-888-922-5398
(This content is being used for illustrative purposes only; any person depicted in the content is a model)
Opioid and heroin addiction is without a doubt one of the most unrelenting public health issues we as a country are facing today. Overdose death rates continue to risk to staggering heights, while politicians, community leaders and organizations all over America are working to find a way out. One of the companies that produces the lifesaving opioid overdose antidote Narcan is talking about their efforts to develop an opioid vaccine.
This isn’t the first time there has been a conversation about possible opioid vaccines. Naltrexone, also known by the brand name Vivitrol, was initially used for combatting alcohol dependence before being utilized in attempt to combat opioid abuse.
A while back in 2015 Kim Janda, a professor at the Scripps Research Institute created a compound he believed could ultimately be used as a heroin vaccine. Since then the research team has made some impressive strides in achieving their goal. The experts from the Virginia Commonwealth University and the Scripps Research Center discovered that the vaccine, which was the first of its kind to reach this phase of preclinical testing, was effective on rhesus macaques, a species of monkeys. This vaccine generates antibodies that neutralize heroin’s psychoactive metabolite and prevents it from acting on the opioid receptors in the brain.
So will this new opioid vaccine be the real deal?
Opioid Vaccine from Walter Reed
On a FOX News segment this past Wednesday, Dr. Mark Siegel, spoke about a new compound coming from the Walter Reed Army Institute of Research (WRAIR) and the NIH’s National Institute on Drug Abuse (NIDA. Dr. Siegel said he was happy to hear it was coming from Walter Reed because of the large issue with opioid drug use among veterans. According to Siegel:
“It uses antibodies to attack heroin or Percocet, or Vicodin; anything like that that’s an opioid, literally you make antibodies. So if it’s in your bloodstream it can’t get to the brain. It doesn’t cause you to stop breathing so you don’t overdose and you don’t have the euphoric feeling.”
According to the interview with Siegel, someone would hypothetically be able to go to a doctor, get inoculated and the opioid vaccine would create antibodies to block the effects of heroin and other opioids.
Dr. Siegel did say that it may end up being a substance that has to be administered periodically. He states human trials with the opioid vaccine have apparently only just started, but animal trials thus far seem to have been very promising.
Dr. Siegel goes on to say that once the opioid vaccine has been administered, the possibility is one could potentially be prescribed another opioid maintenance drug like Suboxone in order to taper off of opioids while not being able to feel the effects of opioids.
Dr. Siegel admits that there is still a lot of testing that needs to be done before the drug can be approved by the FDA, but he believes if the opioid vaccine is successful it could change the entire epidemic.
Opiant Jumps on Opioid Vaccine
A Big Pharma company known for their opioid overdose antidote announced back in late 2016 that they had acquired exclusive development and commercialization rights to the pre-clinical heroin vaccine. CEO of Opiant Pharmaceuticals, Dr. Roger Crystal, said in a recent statement:
“Aggressively addressing heroin addiction is part of Opiant’s mission… This vaccine fits our plan to develop innovative treatments for this condition. The vaccine has promising preclinical data.”
The Opiant Pharmaceuticals aspiration is also to create a compound that blocks the effects of opioid drugs like heroin. Dr. Crystal also said that they would like to develop their own version of the Naltrexone implant as a long-term opioid blocker.
Opiant also says that if further preclinical testing of the opioid vaccine is successful, the company plans to team up with WRAIR researchers in the U.S. Military HIV Research Program to eventually combine the HIV vaccine with the potential heroin vaccine, making a huge leap in the direction of fighting back against two of the biggest issues concerning the opioid epidemic.
Would Opioid Vaccine Work?
The bigger question we keep having to ask when talking about the concept of an opioid vaccine- will it work? Not saying that the vaccine won’t be effective at blocking the brains opioid receptors, but is this an effective strategy to combatting addiction?
One question I would think to ask is will addicts who are trying to overpower the vaccine end up taking even more of the drugs until they suffer other severe health complications. Is blocking the opioid receptors a comprehensive way of protecting people from overdosing on opioids? Which opioids would still be extremely dangerous? Will this work on drugs like fentanyl or carfentanil?
Beyond that, the question also becomes- will addicts quit, or will they use something else? If many can substitute their addiction with another substance, will a opioid vaccine make other drugs more popular?
Only more time and more research will show us how effective the new opioid vaccine could be to helping end the opioid epidemic in America. Right now with statistics being as serious as they are, any avenue that has real potential to save lives should be pursued.
Then I have to ask- with many Big Pharma companies that make Narcan and other opioid antidotes jacking up their prices, will Opiant and other vaccine makers use the miracle drug to exploit the desperation of the epidemic with intense prices?
There is no miracle cure for opioid or heroin addiction yet, but it seems many have not given up hope of finding one. What we do have today is safe and effective treatment options that offer unique opportunities to change your life. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now.
CALL NOW 1-888-922-5398