This article examines the different treatment options for Oxycontin addiction. It looks at who should go to rehab versus who should go to Medication Assisted Treatment like Suboxone or methadone treatment. An explanation is given for what each treatment is and what would be expected of the addict for each option.
There are many different treatment options for addiction to
opiates like Oxycontin. Once you realize you are addicted and want help, it is
difficult to figure out what the best treatment option is for you. Two of these
options are rehab and medication assisted treatment (MAT). MAT includes
Suboxone, Subutex, Zubslov and methadone treatment.
What Is the
Difference between Rehab and MAT?
Rehabilitation Treatment
Rehabilitation treatment or rehab is a residential treatment
facility for drug and alcohol addiction. It is inpatient treatment and
typically lasts 30 days or more. Inpatient treatment means that you stay at the
facility 24 hours a day. If you are physically addicted to opiates like
Oxycontin, you may need a medical detox prior to rehab. Oxycontin and other
opiates are physically addictive. When you stop taking them, you can have
withdrawal symptoms. Withdrawal can be severe or mild depending on how much
opiates you are taking.
Some rehab facilities include detoxification (detox) from
opiates. Detox is a medical treatment to rid the body of opiates or other
drugs. Detox is only done by medical professionals. Medications can be given to
the addicted person to help make the detox more comfortable for the addicted
person. Some facilities use a Suboxone or Subutex taper to help ease withdrawal
symptoms.
Medication Assisted Treatment (MAT)
MAT or medication assisted treatment is outpatient
treatment. Unlike rehab, you do not stay at an outpatient facility 24 hours a
day. If you are in MAT, you will go to the facility for counseling and
medication on a regular basis but still remain living in your home.
There are several types of MAT:
Suboxone
Subutex
Zubslov
Methadone
Suboxone, Subutex and Zubslov
Suboxone, Subutex and Zubslov are medications for the
treatment of Oxycontin and other opiates. They are prescribed by a doctor who
is certified to prescribe these medications for the treatment of addiction. These
medications can be prescribed in a doctor’s office or at a clinic. Clinics that
prescribe these medications also provide counseling. If you are prescribed them
in a doctor’s office, you may need to find your own counselor if you are paying
for treatment through insurance. Most insurance require counseling or they will
not pay for the medication. You may also be required to verify sobriety through
urinalysis or mouth swabs. Medication is usually prescribed for two weeks to a
month. This means you have to see the doctor once or twice a month in addition
to whatever counseling is required.
Suboxone, Subutex and Zubslov contain a drug called buprenorphine. Buprenorphine is an opioid, a synthetic or man-made
opiate. It is a partial agonist which means that at its maximum, it doesn’t
have the same effect as an opiate agonist like Oxycontin. Buprenorphine has a
ceiling effect which means that above a certain dose, it has no effect. This
makes it less likely for someone to overdose while taking this medication.
However, overdose is still possible when it is combined with other drugs.
The difference between Suboxone and Subutex is that Suboxone
contains naloxone. Zubslov is another brand name medication which contains buprenorphine and naloxone. Naloxone was added to Suboxone and Zubslov
to prevent addicts from abusing buprenorphine by injecting it. Subutex is
generally prescribed to pregnant women and other people who cannot take
naloxone. Suboxone, Subutex and Zubslov are taken orally by placing the
medication under your tongue.
Methadone
Methadone is an opioid, a synthetic or
man-made opiate. It is a full agonist. Methadone is prescribed by a doctor at a
clinic. A methadone clinic also provides counseling services to the addicted
person. The laws for methadone clinics vary by state but most require that you
receive counseling once or twice a month. Methadone is dispensed at the
facility and must be taken in front of a nurse. It comes in either a liquid
form or a wafer which is liquefied in hot water and juice. At most methadone
facilities, you have to go to the facility daily in the beginning. Clients can get
take-home doses depending on how long they have been at the facility and how
they are progressing. Take-home privileges are often a reward for sobriety
which is monitored through random urinalysis or mouth swabs.
Which Treatment Is Best
for Me?
Counselors use this rule of thumb to determine the best
treatment for a client: What is the least restrictive treatment that would be
effective for this client? This means we look for a treatment that is effective
and can help the client but without placing them in a restrictive environment
unless it is necessary. For a person who has just experimented with drugs, this
might mean counseling. For someone who is on the path to becoming addicted,
this might mean intensive outpatient counseling.
However, the person who is physically addicted needs a more restrictive
environment for treatment. This means rehab or MAT. Rehab is restrictive
because you have to stay at the facility 24 hours a day, follow their rules and
do everything according to the facility’s schedule. MAT is an outpatient
treatment but it is restrictive because it is long term treatment. Some people
take MAT medications for years or even the rest of their life.
Reasons to Choose Rehab
This is a list of reasons to consider rehab over MAT. If you
meet any ONE of these criteria, consider rehab first before MAT.
Never been to rehab
Have gone to rehab before but never put in much
effort
Went to rehab before but only for other people
and not for yourself
Have not been to rehab for a long time
Have been successful with rehab before but have
relapsed
Young people (under the age of 25 to 30)
Using drugs for a short period (1 to 3 years)
Unemployed and can devote time to their recovery
Want to be completely abstinent
Willing to go to 12 Step meetings
Want to learn about addiction
Want to learn to live without the use of drugs
or alcohol
This
is not to say that if you don’t fit all of these criteria, you should
automatically go to MAT. Even if you meet ONE of these criteria, you may want
to consider rehab. MAT is long term treatment. In my opinion, it is more
restrictive than rehab because you have to make a commitment to this treatment
which could last for years. I think MAT should be considered a last resort when
all other treatment has not led to recovery.
Reasons
to Choose MAT
This
is a list of reasons you may want to choose MAT over rehab. If you meet any of these
criteria, MAT might be the right choice for you.
Unable to leave your life commitments for 30
days or more (This does not include primary caregivers for children since there
are facilities that can accommodate children)
Are fully employed and would lose your job if
you left for 30 days or more
Have been to numerous rehabs and 12 Step groups
with no success
Are prepared to participate in long-term
treatment
Are committed to using no other drugs while in
treatment
No insurance coverage for treatment , could not
afford rehab or find a program to cover the cost
Financial responsibilities that prevent you from
leaving for 30 days or more
Risk losing housing if you leave for 30 days or
more
Health issues which prevent you to leave for 30
days or more
Are not willing to leave home for 30 days or
more
Legal issues which prevent you from leaving for
30 days or more
Pregnancy
Facilities have long waiting lists and you have
an immediate need for treatment
Basically,
I would recommend rehab over MAT unless you have no option to leave for 30
days, cannot find a facility to treat you or are unwilling to go to inpatient
treatment. The other case is pregnancy. If you are addicted to Oxycontin or
other opiates and are pregnant, you cannot be detoxed from opiates. Detox would
put the fetus at risk for miscarriage. MAT is the only approved treatment for
pregnant women addicted to opiates.
This
is not to say MAT cannot be an appropriate treatment for Oxycontin addiction.
Many people believe MAT has saved their life. However, you are still required
to take medication every day. There is a freedom that comes from being
completely abstinent. Knowing that you don’t have to wake up and take anything,
gives an addict a sense of accomplishment and pride. Since this is achievable,
I hope every addict will give rehab a chance before going to medication
assisted treatment.
Medication
assisted treatment involves continuing to take an opioid on a daily basis. It
can be used as a tool to complete abstinence or it can be abused by using other
drugs along with it. People who are already taking one drug are more likely to
take another. You are also responsible for taking the medication properly. This
is difficult for an addict to achieve. Addicts wouldn’t be addicts if they
could control their use of medication. However, this is what is expected of
people on MAT. Methadone is more controlled since you have to go to the treatment
facility more frequently but there are still ways to abuse this medication.
Many
addicts make the mistake of getting involved with other clients at their
treatment facility. Remember that everyone might not be there for the same
reasons as you are. Some addicts go to MAT to avoid withdrawal and not to get
off drugs. They may be continuing to use other illicit drugs which could
trigger cravings and drug use for you.
Before
you make a choice on whether you want rehab or medication assisted treatment,
ask yourself what your goals for treatment are. If you want to live a normal,
drug free life, then rehab is the best choice for you. If you just want to stop
withdrawal and increase your functioning, then MAT may be for you.
Whichever
treatment you choose, the more effort you put into treatment, the more you will
get out of it. Including counseling and 12 Step groups as a part of your
treatment, will increase your chances of success. Working on co-occurring
disorders with mental health treatment, resolving legal issues, reconnecting
with family, developing social support, letting go of friends who still use
drugs, going to school, getting a GED and becoming employed will help you to
lead a normal, drug free life.
Image Copyright: Jonathon Kos-Read