Medication-Assisted Treatment Vs. Abstinence: What Everyone Needs To Know

Recovery is complicated, and if you ask a room full of people how to recover, you will receive a myriad of different responses. The recent explosion of the opioid epidemic has increased our societal awareness of the devastating effects these powerful drugs have on our society. In fact, we’re more keened into treatment options than ever before.

However, which approach is the right approach? What do people need to know about Medication-Assisted Treatment (MAT) vs. abstinence? And how do you choose what’s best for you or your loved one?

Understanding Medication-Assisted Treatment (MAT)

MAT refers to FDA-approved medications that are intended to help support individuals in their treatment of substance use disorders. Used in conjunction with behavioral and other counseling therapies, it can be a powerful proponent in one’s recovery.

MAT has been used for nearly a century to treat addiction, with methadone first being produced in the 1930s as an alternative to morphine. Today, three main medications help treat opioid addiction.

Methadone

Methadone is an opioid agonist dispensed in regulated and supervised clinics. Methadone changes how the brain perceives pain, and it reduces the distressing symptoms of opioid withdrawal. Because methadone itself is an opioid and can be habit-forming and addictive, it is no longer the first line of defense for treating addiction.

Naltrexone

Naltrexone blocks the euphoric and pleasurable effects of opioids by binding and blocking opioid receptors. It is not habit-forming. If the individual taking naltrexone relapses, the naltrexone prevents the feeling of ‘getting high.’

Naltrexone is available in a pill form (taken at 50 mg per day) or in an injectable extended-release form (known as Vivitrol).

Buprenorphine

The FDA approved the partial opioid agonist, buprenorphine, in 2002. Buprenorphine is available in several different forms, and Suboxone (the combination of buprenorphine and naloxone) is one of the most common ones.

Buprenorphine can produce effects that mimic the ‘highs’ associated with opioids. However, the effects are weaker than other opioids, like methadone or heroin. That said, because it can be habit-forming, there is the possibility for misuse.

In response, the FDA has recently approved Sublocade, a breakthrough in the MAT community, as it is the first, injected, extended-release form of buprenorphine.

What Is Abstinence?

Abstinence is a term thrown around frequently in recovery meetings and treatment settings. But what does it mean? The answer? It depends.

Some people define abstinence as the complete avoidance of mood-altering substances. This means staying away from the drug of choice completely. It may also means avoiding other substances that can result in intoxication (i.e., even if the person considers painkillers as the ‘drug of choice,’ they may also abstain from drinking alcohol).

Abstinence works because it’s very black-and-white. It’s a straightforward format to follow, and that simplicity can make the process easier to follow. Many members of AA and other 12-step groups promote abstinence for these reasons. The premise is simple: don’t put certain drugs in your body- at any costs!

That said, abstinence can become complicated in certain situations. For example, what if an individual gets involved in a serious injury that warrants crisis medical attention? Would he or she be able to take opioids- or is that considered breaking abstinence?

What if someone has a history of chronic relapsing and has had several close calls with overdosing? Would medication-assisted treatment be a better approach than total abstinence?  

Medication-Assisted Treatment Vs. Abstinence: Choosing What’s Right For You

Because addiction can be so complicated to treat, it’s impossible to determine which approach will work best with each individual. Some people benefit from taking a trial-and-error mentality. While this may be frustrating and tedious, it may be one of the best methods for determining the appropriate course of action.

It’s important to consider that neither approach tends to work well on its own. Most research suggests that the combination of counseling, therapy, and medical evaluation help improve the odds of a sustained recovery.

Whether you follow abstinence-only sobriety or you take medication for craving reductions, it’s essential to seek support during this process.

At The Edge, we both accommodate and specialize in providing individual treatment that meets our clients’ needs. We have successfully treated many clients adhering to medication-assisted treatment plans, and we have also treated many clients who follow an abstinence-based model.

Ready to see how we can help you? Contact our admissions team today!