Better way to treat opioid addictionBy CHRISTINA DENT,
Michele Tackett of Hattiesburg spent 11 years in active addiction to opioids. She found sobriety and a new life three years ago through the medication Suboxone, one form of opioid substitution therapy known as Medication Assisted Treatment (MAT). MAT is now widely considered the gold standard in treating opioid addiction because of its higher rates of long-term sobriety and lower rates of death in the event of relapse than abstinence-only treatment. Unfortunately it is often stigmatized as “trading one addiction for another,” keeping people from considering it as perhaps the best option to stay alive and have a chance to improve their lives. For Michele, it did both. “I had lost all hope of ever being out of the rat race of chasing, chasing, chasing pills. I couldn’t imagine any kind of future,” she remembers.
She reached a breaking point. “I had lost my fiancé to a drug overdose, and I knew if I didn’t get sober I would die. I knew there was help out there, and I started searching. I found a doctor who explained the changes in my body as a result of my addiction, and he started me on Suboxone. I get up in the morning and take my medication, and I don’t feel anything but normal.”
Dr. Kenneth Cronin of Ridgeland is one of Mississippi’s longest practicing specialists in addiction. He has extensive experience using all three of the approved medications for opioid MAT, and acknowledges that each has its place. But he has found that, “Treatment with Suboxone has provided my patients the most benefit. It has been proven repeatedly to reduce cravings for opioids while producing little sedation, euphoria or respiratory depression. It has dramatically improved one-year and five-year sobriety rates. When paired with appropriate counseling, 12-step practices, and other medications when necessary, long term opioid relapses are rare. This is a marked contrast to the expected 90 percent relapse rate of those given only a few days of abstinence through detoxification, without further treatment.”
Even with MAT’s higher rates of success, some worry that being on MAT isn’t sobriety. Dr. Cronin tries to dispel that myth by helping people understand that, “MAT allows patients to function at their best level without constant fear of relapse.”
Michele’s experience on MAT has been one of sobriety. “The best way I can describe the difference between addiction and recovery is this: Imagine the darkest night with no stars, no hope, no light whatsoever and you’re lost. And then think about the most beautiful day you ever hope to see. That’s the difference between my addiction and my recovery. It feels like two different lives. Suboxone gave me my life back.”
The years of her addiction took a heavy toll on her family relationships, but MAT gave Michele the stability to begin rebuilding not just her life, but her relationships too. “It takes a long time to regain trust again, but I’ve restored my relationships with my family – my mom, my dad, my daughter. They trust me now.”
Family members of addicted people can also be understandably leary of treatment that includes medication. But it’s important to clarify the goal of treatment. If the goal is simply “no drugs,” then abstinence-only is the only option. But if the goal is first to keep people alive, MAT has a higher rate of success. Only then can we work toward stabilizing their life and then improving their life. For many people with opioid addiction, MAT offers the best chance to do all three.
Although some people are able to stop MAT completely after a period of time and maintain sobriety through abstinence, some stay on it permanently.
Dr. Cronin doesn’t see this as failure. “Addiction must be regarded as a chronic illness with potential for relapse. As one’s life in recovery improves and stabilizes, MAT may be discontinued. However, it can take from months to years to heal the brain from the changes that occurred through the addiction. MAT is not a quick fix. It is our best management strategy for life-threatening, relapsing opioid use disorder.”
Michele’s doctor told her the same thing, and she has seen that play out in her own life.
“I’ve been able to taper my Suboxone use down to almost nothing, but even if I have to take a minute amount for the rest of my life, that’s OK. I have a great life now. People need to know that there is life after addiction. Sobriety through abstinence works for some people. And sobriety through MAT works for some people. If families could hear that there are other options, maybe it can save someone else’s life too.”
Christina Dent is the founder of End It For Good, a conservative nonprofit advocating for health-centered approaches to drugs. She lives with her family in Ridgeland.