Allie Severino: What is Medication Assisted Treatment?

 

Hey guys, Allie Severino here with Addiction Helpline America. If you don't already know, Addiction Helpline America is an easy to use easy to navigate online directory that lists every single treatment resource in every single state. Click on the state that you're looking for, type in what kind of resource you're looking for, and it will list every single option near you. Also, you're able to look at all these facilities, their reviews, their photos, their videos... every single thing about each facility is pulled and put onto our site, so it's really easy to find all the information that you need in one place. Today's video is going to be on Medication Assisted Treatment, what is it, there's a lot of different medications that are used, and they can be used in different ways, and it's for two different kinds of addictions, so I want to cover all of that stuff today. I really hope that this video is able to help you guys out in the future if you're considering getting on some sort of MAT program, or have a loved one that is on MAT help you understand a little bit better. You know, there are always lot of opinions surrounding MAT, and medication in general. I think it's really important to touch on the fact that every 16 minutes somebody dies due to an opioid use disorder. And beyond that, double the amount of people die yearly from alcohol than they do from opioids. So we have a serious addiction crisis going on in this country. It's not just opioids. And so it's really important to be educated on the facts.

What is MAT? MAT is FDA approved medication in combination with behavioral therapies. Right now, the only two substance use disorders that are able to be treated with medication are alcohol and opioids. When we talk about behavioral therapy in conjunction with medication, what do we mean by behavioral therapy? Well, that's either, you know, therapy, counseling, one on one, peer groups, family groups, family therapy, stuff like that. So there are three medications That are primarily used they are Vivitrol, buprenorphine and methadone, and that means medication in conjunction with behavioral therapy. So let's start talking about what these medications are and what they do.

So we're going to start off with the first medication which is buprenorphine. buprenorphine is used to treat solely opioid addiction. That can be any sort of pharmaceutical opioid like hydrocodone, oxycodone, Oxycontin, or can also include illicit drugs, such as heroin and fentanyl. Buprenorphine is commonly used in detox. Why? When used properly, buprenorphine can alleviate opioid withdrawal symptoms, and it also can really decrease feelings of craving for that drug. buprenorphine is actually the first medication like this that can actually be prescribed and obtained through a doctor's visit seeing a doctor. Any doctor that has the proper waiver, can actually write you a prescription for Suboxone, subutex, buprenorphine. When you see them there's an induction period they help you get on the medication. If you take this medication too close to the lifetime you use, you can go into something called precipitated withdrawal. (we'll also get into that), but you can go see a doctor on an outpatient basis and they can help you get on the medication, stabilize you and they'll monitor through the process. Buprenorphine alone does have a potential for abuse, and it also has a potential for prescription diversion. This is due to opioid like effects. There are formulations of buprenorphine where they include Naloxone. This is not to be confused with naltrexone, but they'll use the lock zone in with the buprenorphine. And that is usually under the brand name Suboxone, the most common brand name. Suboxone actually lowers your chance for abuse with this medication, because it kind of blocks the robust opioid-like effect and it also makes it so that a person can't misuse the medication by, let's say, trying to use it intravenously. If somebody gets this medication and they do try to use this drug intravenously, they will get very, very ill. Then Naloxone will initiate withdrawal symptoms if you guys have never heard of precipitated withdrawal, that is what what is going to feel like. Basically, what that is, is detox symptoms, regular withdrawal symptoms, times 100 for a few hours. You're going to go through that if you try to misuse this medication. Again, buprenorphine is a partial agonist. They have a few different forms of this medication that you can receive. One of them is called Probuphine. So we have Subutex, Suboxone, Zubsolv, and Bunavail. All of those medications go in your mouth. So either you let the pill or strip dissolve under your tongue, or on the side of your cheek. Probuphine is an implants and what it does, it's four rods that are implanted into your arm, and it gives you six months worth of medication without having to take it every single day. So what the implant will do is it will slowly read, releases medication into your body every day for six months. They do not recommend getting this done more than two times, so more than a year's worth of the implants is not recommended. But in 2016, the FDA did approve that for use. And I'm sure that helps some people because they're taking the proper dosage every day. It's hard to deviate from that unless you literally take the implant outside of your body. It's hard to abuse and, like I said, you're getting the correct amount of medication every single day. The one thing I do have to say though, about the implant or the shot, which we're going to talk about next, which is Sublocade is that try the medication in a pill form first, you know how it reacts with your body before you have something that is inside you for 30 days to six months. Sublocade is an intramuscular shot. So basically, you'll get a shot once a month. The shot will then disperse into your bloodstream every day for 30 days again, taking away the need to take medicine every day, taking away the ability to abuse the medication, while also delivering you know, the daily recommended dosage for that person.

The next medication that we're going to talk about is methadone. Now I'm sure you guys have heard about methadone before since it has been around for a very long time. Methadone was actually invented in Germany. During World War Two, America actually took the patent from Germany for methadone. So we've had it for that long. Most of you guys have also heard about methadone clinics. That is how methadone is actually dispensed and dispersed to the people who are on it. They go daily to a methadone clinic. Usually they're open for a few hours in the morning. The patient has to get there on time. They usually have to go to a group, see a therapist, and then they're dispense their medication daily. Methadone is a full opioid agonist. So it acts very much like other opiates, but it is very long acting, much longer acting than heroin or hydrocodone. And so because of the long-actingness of these drugs, the effects are a little bit milder and they shouldn't impact a person's day to day life. Many people that I've I've seen (this my opinion), many people I've seen get on methadone, they're very tired. Their first week or two on this medication, the one positive of methadone would be that you don't have to wait until you're in withdrawal. To get on the medication. Some people have such a hard time hanging on for that "24 hours" before they can take buprenorphine, that they continuously fail. But again, it does make day to day living a little bit more difficult, because you have to go to a methadone clinic and eventually you will get "take homes", but that is after being on the program for a little bit, having positive or negative drug screenings, and doing all of your therapy in groups etc. Again, methadone is the full opioid agonist. It can be taken through a pill, a wafer, or liquid form. The dosing is every single day, and you would get that dosage through some sort of opioid treatment program like a methadone clinic.

The next drug we're going to tackle is Naltrexone, again, not to be confused with Naloxone. Naloxone is what Narcan is made out of. Narcan is Naloxone. Yes, Naloxone is Suboxone... (I'm not a pharmacologist!). Naltrexone is another medicine that either comes in an implant, an injectable, or a pill form. The injectable form, and the most common one, I think, prescribed is known under the brand name is Vivitrol. So what Vivitrol is it's an intramuscular shot and it lasts 30 days. Oral dosing, of course happens one time a day. Unlike buprenorphine, and methadone, Naltrexone has no potential for abuse and no potential for diversion. And that's because with Naltrexone, there are no opioid like effects coming from this medication. What this medication does is totally block your opioid receptors. That's how the medication works. What is a blocker? What it means is that if you're on this medication and then you try to ingest opioids, or alcohol, you're not going to feel any of the euphoric feelings that you think you're going to feel though. So you're not going to experience usual euphoria or high associated with those two substances. Now very important to know, and to note, while Naltrexone blocks a person's ability to feel the enjoyable effects of alcohol, while you're not feeling the more rewarding, drunken like effects, you still will have impaired decision making impaired judgment and impaired coordination. So basically, you're just going to get all the bad stuff, and you're not going to feel any of the good stuff. Doesn't seem worth it to me. Another thing some people will attempt to override their Vivitrol shot with opioids by using a large dose. Now you are not going to feel high, you're not going to get high. If you have a Vivitrol shot in you, you are not going to feel opioids, but you can still overdose. Your respiratory system can still slow down, but you are still not going to get the euphoric effect. So I think it's really important for everyone to understand that and to not try to override this medication, it is not going to work. The great thing about Naltrexone again, is that it's not addictive and you don't feel anything from it. All it does is block the receptors in your brain. Again, this can be used for alcohol, and it can be used for opiates.

The next medication we're going to go over is pronounced Di-sul-fram ("Disulfiram"), also known as Antabuse, if you guys have never heard about this medication, it's pretty interesting. It is used just for those who have addictions to alcohol. And what it does is it helps curb drinking behaviors by eliciting really unpleasant effects when alcohol is consumed. So some of these awful side effects that happened about 10 to 30 minutes after you consume alcohol include things like sweating, vomiting, chest pain, headache, flushing, anxiety, blurred vision, weakness, heart palpitations, vertigo and confusion. So obviously these are you know, symptoms that nobody wants. And so the idea is that, if that's going to happen when you drink you're not going to drink. This was a very common medication to use for a very long time, but now I feel like it is much more common for providers and physicians to use drugs like Vivitrol when working with those who are struggling with alcohol.

So how do you get on Medication Assisted Treatment? What do you do? You're going to call a provider near you, you can go to AddictionHelplineAmerica.com and see every single place near you that provides Medication Assisted Treatment,. If you decide to enter a treatment program, just like every other program, there's going to be an assessment and the assessment has three main goals goal.

Goal One would be to properly diagnose the substance use disorder. Goal Two is to evaluate the severity of the addiction, and Goal Three would be to assess for any co-occurring mental health or substance use disorders.

Once the staff has assessed your condition, they're going to figure out whether or not you're a good candidate for MAT. Who is a good candidate for MAT? Per SAMHSA, you are a good candidate for MAT, if you have an official diagnosis of addiction to alcohol or opiates, you are willing to fully comply with the prescription instructions, you like physical health problems that the medication might potentially exuberant, and the fourth one is that you are fully educated on your other options.

In my opinion, if you have not tried abstinence based treatment before, I really suggest you try. If it's not working, though, there is no shame on using medication to stay alive. At the end of the day, drug addiction, alcoholism are brain disorders. And so there is no shame in using medication to recover. Everybody's recovery looks different. And it's important that we don't shame each other and we don't throw stigma at each other. If you have gone through recovery, if you have gone through addiction, you know that it is a hard enough road on its own. You know, you don't need to be put down and shamed for the way that you choose to recover. Our job at Addiction Helpline America is to give you guys all the tools, resources and education that you need to really make an informed decision about your recovery process.

I hope this video helps you, if there's anything you think I forgot, comment down below. If this video helped you or you even just liked it, give us a Like, give us a Share, Subscribe - we would love to have you in the Addiction Helpline America family. I look forward to making your next video. If you have any video requests, please comment them down below. I'd be happy to make them. Hope you all have a fantastic day and I will see you soon. Bye.

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