Providing evidence-based treatment for opioid addiction in rural areas

Providing evidence-based treatment for opioid addiction in rural areas

Publication date: Apr 14, 2019

Community Medical Services has provided treatment to those with opioid use disorder (OUD) for more than 30 years, utilizing a combination of treatment methods such as individual and group counseling, peer support and medication management.

Below are some of the questions we are often asked related to opioid use disorder (OUD), which we share with the hope that it provides a different perspective to the Graham County community regarding finding the best treatment option for individuals suffering from OUD.

The addiction treatment infrastructure in the United States was built over the last several decades to primarily treat alcoholism and other substance-use disorders without the use of medications; thus when talking about addiction treatment we repeatedly hear of a need for -beds” and detox facilities, which historically have not incorporated Medication-Assisted Treatment (MAT) maintenance into their treatment protocols.

In fact, SAMHSA, the CDC, the World Health Organization (WHO) and all other major global and national health agencies agree that MAT is the most effective treatment for those suffering from OUD and that abstinence-based treatment (treatment without MAT) works for approximately 8 percent to 10 percent of those suffering from OUD.

That is why modalities such as detox (even with accompanying short-term MAT) and 28-day residential treatment without accompanying MAT maintenance does not work for most people suffering from OUD.

However, research tells us that while MAT is the most preferred treatment for this disease and methadone treatment has the greatest potential for healing the patient’s brain, it is a long-term course of treatment.

Aren’t treatments such as methadone and buprenorphine, which are both opioids, simply replacing one addiction for another?

For instance, when you look at global studies where treatment programming and the cost to the patient are similar between medications, you see that approximately 70 percent to 80 percent of patients are on methadone, and 20 percent to 30 percent are on buprenorphine, which may allude to the appropriate genetic responsiveness ratios to each medication.

In an attempt to determine the best treatment modality for the largest number of people, researchers have randomly assigned patients to different modalities in the same setting and found that methadone treatment works (even in insufficient doses) for a larger number of people than other medications.

As such, after a period of abstinence (or naltrexone treatment), the brain becomes hyper-sensitive to opioids, which is the reason many people overdose after detoxing.

Methadone however has been shown to reverse the effects of downregulation caused by opioids and thus with the course of methadone treatment, some patient’s receptors can begin to regenerate, and their bodies can begin to heal from the damages caused by their opioid use.

Concepts Keywords
Abstinence Drug rehabilitation
Addiction Organic compounds
Alcoholism RTT
Brain Chemical compounds
Brain Scan Opioids
Buprenorphine Treatment protocols
CDC Counseling
CEO Medication management
Counseling Maintenance treatment protocols
Depression Addiction treatment infrastructure
Detox Disease
Downregulation Buprenorphine
DSM V Methadone
Effective Dose Morphinans
Endorphins Euphoriants
Epidemic Ketones
Gene Opioid use disorder
Genetic Naltrexone
Global National
Graham County
Hepatitis
Heroin
HIV
Imperative
Lengths
Mary Jane
Methadone
Modality
Naltrexone
Neurobiologist
NIDA
Opiate
Opiate Receptor
Opiates
Opioid
Opioid Addiction
Opioid Dependency
Opioid Epidemic
Opioids
Overdose
Receptors
Relapse
Rural Area
Safford
SAMHSA
Stigma
Stimulus
Surgeon General
The Addiction
Treatment Modality
WHO

Semantics

Type Source Name
gene UNIPROT CLMP
gene UNIPROT BAD
disease MESH hepatitis C
disease DOID hepatitis C
pathway BSID Hepatitis C
drug DRUGBANK Diamorphine
disease MESH depression
drug DRUGBANK Naltrexone
drug DRUGBANK Buprenorphine
disease MESH relapse
disease MESH opiate abuse
drug DRUGBANK Methadone
gene UNIPROT SSRP1
gene UNIPROT MAT1A
gene UNIPROT ACAT1
pathway BSID Alcoholism
disease MESH alcoholism
disease DOID alcoholism
disease MESH death
disease MESH Community
gene UNIPROT BEST1
disease MESH suffering

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