Medication-assisted treatment (MAT) may be controversial among some 12-Step recovery cultures, but the reality is that both are powerful tools. The idea that the two conflict is an ideological, non-scientific opinion that has morphed into myth. MAT is not at odds with the program but rather a complementary evidence-based therapy. This destigmatizing analysis will discuss how MAT and the Twelve Steps combine into a power toolkit for successful recovery. We will address myths and misconceptions as well as how to advocate for yourself, both with providers and others in recovery.
Fact: Some People in Recovery Need MAT
MAT proves particularly vital for opiate recovery. Women who learn they are pregnant while using often must use MAT to prevent fetal distress. Objectively, there is no reason you can’t do a program, participate in therapy, and take medication. Some factors that influence who needs MAT during recovery include the length of problematic use, tolerance, and individual health concerns. These issues help your prescriber understand the best medication plan for you.
Fiction: MAT Patients Aren’t “Really” Sober
The highly stigmatizing myth that MAT patients are “still using” is as dangerous as it is false. Indeed, the fear that starting MAT is the opioid equivalent of jumping from the frying pan to the fire prevents people from seeking treatment options. The reality is that the medicines currently used for managing problematic opioid use do not produce a recreational “high.”
Rather, methadone and buprenorphine mitigate withdrawal symptoms. A person stable on either is as lucid, alive, and awake as someone not on MAT. These substances both block effects of classical opiates at the correct doses. Many people in recovery find it helpful to know using these substances is pointless and dangerous.
Utilizing MAT in a 12-Step Program
If someone in your 12-Step Program is confrontational or insulting about your medical choices, you have options. The individual or culture of the program member is likely informing their beliefs. However, everyone has beliefs. Not all are worthy of consideration, let alone feeling shame or doubt over.
The body of evidence around MAT is solid. If someone tells you that you must be abstinent from all substances, remember, nobody speaks for the entire organization. When you encounter such people, they are more problematic to your recovery than any medication. Move along, and understand you don’t need to tell anyone about your personal choices around your path.
Seeking a sponsor who understands and respects MAT can help you get the most from a 12-Step Program. At West Coast Recovery Centers, many of our clients work multiple programs and participate in therapy. We allow clients the freedom to choose their personal paths and avoid stigmatizing medication when appropriate and desired. Further, we support clients in transcending the stigma of substance use and mental health disorders.
Fact: MAT Includes Multiple Options You Can Choose From
West Coast Recovery Centers can advise you on medication matters. Someone struggling with alcohol use disorder (AUD) will require different medications, for instance. None of these medications interfere with your ability to think clearly or receive wisdom from a spiritual program. Some 12-Steppers may say these medications “block you off” from your Higher Power. But don‘t accept this superstitious and condescending premise without question.
The reality is that taken properly, nobody should be able to tell that you take anything for OUD at all. Many people who use opiates need these medicines to stabilize enough to appreciate and reap the benefits of spiritual programs and therapies.
Old-school 12-Steppers will sometimes insist the Twelve Steps and ”cold turkey” are the only ways to get and stay sober. At West Coast Recovery Centers, we firmly reject the notion that there’s only one way to recover. You can meet your goals with both tools and ignore juvenile and judgmental people.
Currently, there are three key FDA-approved MAT treatments for opioid use disorder (OUD). The following are the current options:
#1. Buprenorphine Products
Suboxone and Subutex remain the most popular choices for OUD. That said, transdermal patches and even a monthly injection are alternatives. Buprenorphine is a long-acting partial opioid agonist. Abusing the substance is pointless. Products like Suboxone include naltrexone to deter injection, as it causes painful withdrawal symptoms.
#2. Methadone
Methadone is an older but incredibly effective tool. Because it has opiate agonist properties, the medication is tightly regulated at the federal level. Access is sometimes difficult, as both public and private clinics must meet the standards for an opiate treatment program to dispense methadone. Taken as prescribed, the medication is highly beneficial, particularly for treatment-resistant OUD.
#3. Naltrexone
The same substance used in Narcan can be highly effective for relapse prevention. Of the three listed here, it is the entirely non-opioid non-narcotic option. Naltrexone is generally indicated for its deterrent effect. Higher severity OUD may require buprenorphine or methadone.
Fiction: MAT Is for Life
MAT is a multifaceted tool with multiple applications. You may elect to use choices like buprenorphine for detox or a pre-defined period of time. Those with lengthy problematic using history and heavy tolerances may prefer maintenance treatment.
The overall goal of maintenance therapy is stability. Some individuals feel safer from relapsing on their maintenance medications. These people may freely choose to remain on a medication like methadone lifelong. Some see it as insurance against relapse and would rather take medication than return to life on IV heroin.
While it is true that many do remain on maintenance for months or years, the choices around tapering remain yours to make. Some individuals prefer to limit the use of medications to detoxification. If you wish to adhere to a short timeline, you can. The key is communicating and developing a proper treatment plan alongside your provider.
At West Coast Recovery Centers, MAT is acknowledged for the useful, evidence-based treatment modality it is. We recognize that many of our clients need this tool to overcome problematic using successfully. Our environments offer access to multiple spiritual activities and recovery programs. We do not believe there is a one-size-fits-all solution for recovery. Your personal recovery path is up to you to decide, but we are here to connect you with all of the resources at our disposal. We respect your autonomy while offering therapeutic and practical guidance for building your new life in recovery. When you partner with West Coast Recovery Centers, you receive highly individualized treatment. Contact our care team at (760) 492-6509 to learn more today.