The most effective approach to treating patients with opioid addiction is to prescribe a long-acting oral opioid–like buprenorphine or methadone–as part of medication-assisted treatment (MAT). There are three equally important parts of MAT: medication, counseling and support from friends and family:
- Medication: Both methadone and buprenorphine are long-acting opioids that reduce opioid-withdrawal symptoms and reduce cravings in patients with opioid use disorders. As a result, they can allow patients to regain their normal state of mind and be free of drug-induced highs and lows. Medication can free them from incessantly thinking about the drug and seeking their next high. These changes give patients the opportunity to focus on life changes that can help them return to healthy, productive living. Addiction is a serious, lifelong condition; consequently, maintenance treatment over years, or even a lifetime, is often necessary to maintain long-term recovery.
- Counseling: Medication-assisted treatment is most effective when it is administered as part of a cognitive behavioral approach with additional patient participation in a self-help group. The behavioral approaches that are used are similar to those that are valuable for other chronic, relapsing conditions (e.g., diabetes). Motivational interviewing is particularly effective.
- Support: Family and friends can provide support that is needed to help treatment.
Use of MAT is not simply substituting one addiction for another. Unlike people who are inappropriately using pain pills or are using heroin, patients who properly take buprenorphine as part of MAT have much greater likelihood of getting and keeping a job, having stable and joyful relationships with family members and friends, and staying out of trouble with the law. In addition, there is no risk of hepatitis or HIV transmission with appropriate use of MAT medications. Properly delivered MAT has been shown:
(1) to be safe and cost-effective;
(2) to improve social functioning; and
(3) to reduce the risks of death, overdose, infectious disease transmission, and criminal activity.