In 2018, the US passed the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) law to help battle opioid addiction. As of October 2020, all 50 states must provide insurance coverage for those seeking an opioid treatment program.
This is wonderful news for anyone struggling with opioid addiction. Experts estimate that as many as 16 million people worldwide suffer from opioid use disorder (OUD). This includes more than 3 million Americans.
Do you or a loved one struggle with OUD? Have you started researching opioid treatment programs (OTPs)? Are you wondering what the treatment process is like and which methods are most effective?
In this post, we’ll discuss the most effective treatment methods used in opioid treatment programs today. We’ll also point you in the right direction for opioid addiction help in your area.
Understanding the “Whole Patient” Approach
In recent years, you may have heard the terms “holistic health” or “integrated healthcare.” Whatever you call it, the goal is the same: to treat not only symptoms but the whole person.
This might include:
- Physical illnesses and symptoms
- Mental and emotional health problems
- Behavioral issues
- Stress, anxiety, and life crises
- Lifestyle management
- Prevention & wellness
Years ago, opioid treatment consisted of little more than managing withdrawal symptoms and then sending the patient on their way. Not surprisingly, most soon succumbed to their addiction again. It didn’t take doctors long to realize that more was needed to battle the worsening opioid pandemic.
Over time, it became evident that recovery required more than nonpharmacological treatment options for pain. It also required tools to empower the patient to avoid their substance addiction in the future.
Research shows that the best opioid treatment program combines medications with psychosocial interventions.
This may include contingency management therapy, which uses positive reinforcement to encourage abstinence from drug use. It also includes cognitive behavioral therapy (CBT), which empowers patients to recognize and avoid tempting situations. To help patients maintain abstinence, peer support also plays a powerful role in the recovery process.
In other words, a “whole person” multi-prong approach to recovery addresses the root causes of addiction. These vary by individual, ranging from depression and anxiety to chronic health issues to family influences on drug abuse. By identifying and working through these underlying issues, the patient is better equipped to make a full recovery.
Of course, getting cravings under control is the first (and very important) step. This is where medication-assisted treatment comes in.
Medication-Assisted Treatment (MAT)
At the core of any successful opioid treatment program, you’ll find medication-assisted treatment (MAT).
At first glance, this might seem counterintuitive. Why would you give medication to someone who’s trying to wean themselves off an opioid addiction? Isn’t it just replacing one substance dependency with another?
Not exactly. These prescribed medications play many key roles including:
- Normalizing brain chemistry
- Reducing and relieving psychological cravings
- Blocking the euphoric effects of opioids
- Normalizing body functions without the negative effects of opioids
Depending on each patient’s needs, doctors may choose to use one of three MAT medications: methadone, buprenorphine, or naltrexone. Let’s take a closer look at each of these medications and how they offer opioid addiction help.
Methadone
Morphine, heroin, and prescription opioids work by activating opioid receptors inside the brain. Methadone works as a synthetic opioid agonist, meaning it operates on the same receptors.
However, unlike actual opioids, methadone activates these receptors slowly and without producing a euphoric reaction. This means the patient gets relief from withdrawal symptoms and drug cravings without the harmful effects of taking opioids.
Doctors have successfully used methadone since 1964, making it one of the oldest treatment methods for OUD.
Buprenorphine
In 2002, the FDA approved a new medication for opioid treatment programs to use. Buprenorphine acts as a partial agonist for opioid receptors. It binds to them the same way that methadone does, but it doesn’t activate them as powerfully as full agonists do.
What have researchers found? Buprenorphine is just as effective as methadone when given at a sufficient dose for a sufficient period of time.
Another bonus of buprenorphine is it’s available in many different forms. The original drug approved in 2002 was in tablet form, and a sublingual version was approved in 2010. More recently, in 2016 and 2017, the FDA also approved subdermal implants and once-monthly injections.
Naltrexone
Another common option for opioid treatment programs is the medication Naltrexone. Unlike the others medications we discussed above, Naltrexone works as an antagonist to opioid receptors.
What does this mean, in plain English? Rather than harmlessly activating opioid receptors, it blocks them instead. And rather than controlling cravings and withdrawal symptoms, it prevents opioids from producing their typical euphoric effects.
Naltrexone has been FDA-approved in pill form since 1984 and in an injectable form (Vivitrol) since 2010. For many opioid treatment programs, it’s the go-to medication choice for addiction help.
Cognitive Behavioral Therapy (CBT)
Medication-assisted treatment is a vital component of many recovery plans, but it’s not the only factor. These medications can do wonders for addressing the physical aspects of addiction. However, more is needed to fully overcome opioid addiction.
As we discussed earlier, the best programs adopt a holistic approach. The program considers the patient’s behavioral patterns, as well as their mental and emotional health. In other words, each patient also needs to address the behavioral and psychosocial aspects of their addiction.
This is where cognitive behavioral therapy comes in.
If you’re not familiar with CBT, here’s a brief introduction. It’s a type of structured talk therapy (or psychotherapy) with a licensed mental health counselor. It’s based on the idea that most psychological problems, such as addiction, are the result of faulty thinking and learned behavioral patterns.
How Does CBT Work?
The goal of cognitive behavioral therapy is to identify and change these negative thoughts and behaviors. This could include:
- Recognizing distorted thoughts that lead to addictive behaviors
- Using problem-solving skills to tackle difficult situations
- Gaining deeper insight into the behaviors and motivations of others
- Developing more self-confidence and belief in one’s abilities
- Learning how to tackle fears instead of avoiding them
- Focusing on calming techniques for the mind and body
- Role-playing scenarios to prepare for tempting or problematic situations
Not every CBT session will use all of these methods and strategies. Instead, the patient and counselor will work together to identify and understand the problems. Then they’ll develop a strategy for treatment.
The ultimate goal of CBT is for the patient to become their own “therapist.” They’ll develop critical thinking and coping skills that will enable them to make changes to problematic thinking and behaviors.
Interestingly, CBT places more emphasis on the present and the future than the past. Although the counselor needs to know some details about the patient’s history, they’re more interested in developing skills that will empower the patient in the future.
Beat Addiction Recovery has developed a CBT curriculum that includes 35 different modules for a patient and therapist to work through together. Each one focused on an essential component of substance abuse disorders, treatment, and recovery.
Ongoing Peer Support
The combination of MAT and CBT is at the heart of any successful opioid treatment program, and its success is well-documented. However, there’s one more important piece of the puzzle we need to address: peer support.
What makes peer support different than other professional relationships, such as patient-doctor or patient-therapist? It offers a whole different level of understanding, acceptance, and validation. This is because the other person has been through a battle with addiction themselves.
The person on the other side of the support group has “been there, done that.” They’ve gone through the recovery process and made the needed lifestyle changes. They understand the fears, the uncertainties, and the temptations that each patient faces.
For this reason, the Beat Addiction Recovery program features a live 24/7 Peer Support app. This app is fully HIPAA-compliant and available for six months (or longer) during and after an opioid treatment program.
How does this peer support app work? It pairs patients with similar profiles — age, gender, the substance of abuse, etc. — via phone, text, or video chat. It also has enhanced features like GPS monitoring and tracking, as well as remote drug testing.
For patients at any phase of the recovery process, this extra opioid addiction help can be just the boost they need to conquer their destructive habits once and for all.
FAQs About Opioid Treatment Programs
As we round out our discussion of OTPs, let’s discuss a few commonly asked questions about addiction help.
Who Is Eligible for an Opioid Treatment Program?
Whether you’re considering this as an option for yourself or a loved one, here are some factors the OTP provider will consider:
- Being diagnosed with opioid use disorder (OUD)
- History of being prescribed Vivitrol or similar medications
- The severity of the addiction (length of use, amount and frequency of use, etc.)
- A history of diverting or attempting to override medications
- A history of drug overdose
- A concurrent addiction to alcohol or other drugs
- Counterindications of MAT, such as pregnancy, liver disease, or respiratory disease
Because each patient and each case of addiction is unique, the program will evaluate potential patients and make customized recommendations for treatment.
What Can Patients Expect During the Treatment Program?
Again, the answer varies depending on the severity of the addiction, the patient’s health, and many other factors. Outpatient treatment may be suitable for some, while others need inpatient or even hospital treatment (at least in the early stages).
If you’re admitted into an opioid treatment program, here are some things the team may ask of you:
- Taking MAT medications as prescribed
- Attending all scheduled medical and counseling appointments
- Participating in group therapy or one-on-one therapy (or both)
- Regularly getting urine tests or other types of drug testing
- Involving your immediate family members and close friends in your recovery efforts
- Developing your own support network through peer counseling, a 12-step program, or other means
- Completing your full course of recommended care, including extended care after treatment ends
Each individual’s journey to recovery looks different, so there’s no “one size fits all” answer that works for everybody. Your doctors and therapists will develop a treatment plan customized to you and your needs.
Can I Do MAT Without CBT or Peer Counseling?
Many patients wonder if they can opt for medication only while bypassing the other aspects of the opioid treatment program. In most cases, the answer is no.
Why? For the best possible chance of success, it’s vital to address more than just physical cravings and symptoms. To achieve and maintain a clean, sober lifestyle, you also have to address the social, psychological, and behavioral aspects of addiction.
Medication-assisted treatment is a vital first step. It eliminates the cravings and withdrawal symptoms that can easily overpower your recovery attempts. Once these feelings are suppressed, you can then focus on the other aspects of your addiction and move forward with the recovery process.
Counseling sessions with peers and therapists, both in group settings and one-on-one, help to uncover the deeper factors that led to your addiction. Once you’ve identified these, you can take positive steps to address and overcome them.
Looking for an Opioid Treatment Program Near Me?
It’s true that recovery is a highly individualized process. What works for one person may not work for another.
Overall, however, patients experience the best chances of success when their opioid treatment program takes a “whole patient” approach. Rather than simply treating cravings or symptoms, these programs give patients the tools they need to overcome their opioid addiction once and for all.
Medication-assisted treatment combined with cognitive-behavioral therapy provides the necessary one-two punch. Thousands of people have successfully won their battle against opioids, and you can too.
Are you ready to take that all-important first step? Would you like to find a “whole patient” opioid treatment program in your area? Click here to find a Beat Addiction Recovery provider near you.