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The opioid epidemic has come to be what is now called a national crisis with a range of problems and severities that extend from infants suffering neonatal withdrawal syndrome (NAS) to the elderly who are increasing in numbers along with others using heroin and opioid painkillers to support their habits.
The preoccupation with maintaining an opioid dependency, preventing impending withdrawals when the drugs wear off, and relapses after attempting to quit can be as demeaning as it is destructive, painful, and dangerous.
Regardless of race, gender, social status, or the instilled protective factors that many of us take for granted, opioids have a special propensity to change the way the individual thinks, feels, or behaves after several uses of the drugs.
An individual cannot know beforehand exactly how a drug will affect him or her because there is great variability in this response, depending on the drug and the specific dose exposure, the individual’s biological and psychological state, and the social circumstances.”
Why is MAT so Important?
Many opioid dependents exist in a vicious cycle of intoxications and withdrawals that manifest into pathological pursuits of the rewards that that these drugs are known to produce. Over time and tolerance, it takes more amounts and frequencies to satisfy those desires and large majority of these individuals will develop complications they never imagined being involved in.
Many overdoses occur in the desperate hurries to get the opioids into the system as quickly as possible via snorting, smoking, or injecting and when these individuals relapse at high rates and their tolerance has been decreased in the recovery attempt, they are all the more vulnerable.
IV use is a primary concern elevated by opioid painkiller diversions, overprescribing practices, and switches to heroin that, along with the use of opioids in conjunction with other central nervous system depressants, have contributed to the rises in overdoses and deaths from these types of drugs.
Over 70% of long-term PWID (persons who inject drugs) may be infected with HCV”. HCV (hepatitis) infected individuals are sometimes, co-infected with HIV without knowing that they have these types of communicable diseases placing a higher risk to others who have no involvements in drug abuse or the associated behaviors.
Benefits of an Opioid Treatment Program (OTP)
Opioid treatment programs (OTP’s) are overseen and certified to deliver medications to treat opioid use disorders. With an opioid addict, the pursuit of rewards such as getting high, to satisfy cravings, or to relieve adverse symptoms of withdrawals can persist for a long time after physically detoxing from the opioids and unfortunately, many will relapse within a few days or weeks without the additional help of MAT to help them manage their conditioned state.
Methadone has the longest running history of effectively treating opioid addictions in detox and maintenance, but, the partial agonist doses of buprenorphine may be preferable to some for its milder effects.
Studies have supported the view that opioid addiction is a medical disorder that can be treated effectively with medications administered under conditions consistent with their pharmacological efficacy, when treatment includes comprehensive services, such as psychosocial counseling, treatment for co-occurring disorders, medical services, vocational rehabilitation services, and case management services.
Expanding Access to MAT
Unlike methadone treatment, which must be performed in a highly structured clinic, buprenorphine is the first medication to treat opioid dependency that is permitted to be prescribed or dispensed in physician offices, significantly increasing treatment access.
Today, methadone clinics are nestled in a variety of atmospheres and settings where the providers are SAMHSA-certified to dispense methadone under opioid treatment program (OTP) guidelines set forth in Title 42 of the Code of Federal Regulations (CFR) 8.
Improved treatment access through the Affordable Care Act requires coverage for substance abuse treatment services as essential health benefits. In a March, 2016 Whitehouse.gov press release, the President’s FY 2017 Budget calls for “$1 billion in new mandatory funding over two years to expand access to treatment for prescription drug abuse and heroin use.”
The funding recognizes the severity of America’s opioid epidemic and includes “$920 million to support cooperative agreements with States to expand access to medication-assisted treatment for opioid use disorders.” In line with these measures to address what is now being called a national crisis, is the advancement of buprenorphine access allowing qualified physicians to increase their patient limits from 100 to 200.