How is it that nearly one in three people know someone who is or was addicted to opioids, yet the current model of intervention for such a common problem is so ineffective? Why are people still allowed to suffer unnecessarily while putting their well-being at dire risk as they await appropriate opioid use disorder treatment? Why do clinicians, public health officials, and the criminal justice system focus so heavily on the addiction, but not the person living behind it?
According to the National Institute on Drug Abuse (NIDA), nearly one-third of people prescribed prescription opioids misuse them, and approximately 12% will go on to develop opioid use disorder. The idea that this powerful class of painkillers is a “gateway” drug is nothing short of accurate—fully 80% of people using heroin preceded their illicit drug use with an opioid prescription.
There must be another way. But before we can explore alternate opioid use disorder treatment options, it’s helpful to have a better understanding of the current standard of care.
Today’s Opioid Use Disorder Treatment
Benefits and Drawbacks of Current Practices
The official position of the American Society of Addiction Medicine is that medication-assisted treatment (MAT) is the most effective treatment for opioid use disorder. MAT involves the combination of psychosocial therapy (provided in inpatient or outpatient settings) and opioid replacement medications. Research suggests that this multi-disciplinary approach is more effective than either of the two modalities (behavioral interventions or replacement drugs) alone.
While it may be well-intentioned, the model of MAT contains significant flaws. First, consider the medications commonly used: methadone and buprenorphine medications such as Suboxone, Subutex, Belbuca, and Sublocade.
These opioid replacement drugs are approved and regulated by the U.S. Food and Drug Administration. Under the MAT model, patients are given opioids (in addition to cognitive behavioral therapy or other psychosocial interventions) to support their addiction—but presumably in carefully regulated dosages to prevent withdrawal and overdose. Unfortunately, many physicians prescribe buprenorphine-based drugs like Suboxone with no contingencies about psychotherapy nor regular communication between the prescriber and mental health care professional. This lack of follow-through fails to ensure that patients are receiving an adequate treatment plan based on their needs and progress, which is a powerful example of providing MAT drugs is not the best solution, unless there is a comprehensive multi-facet treatment and detox plan behind it.
For several people undergoing MAT, their frustration doesn’t end with the unpleasant and often debilitating side effects of replacement opioids, including anxiety, insomnia, constipation, weakness, and impotence. Another understandable concern is that they essentially remain opioid-dependent and reliant on medications to function—albeit legal ones and under the supervision of a physician. Taking prescription opioids indefinitely is not the ultimate goal for many of these individuals—however, this is precisely the issue MAT can lead to if there is not a comprehensive diagnosis, individualized treatment, and exit plan.
Another problem with MAT, as noted by the nonpartisan organization Pew Charitable Trusts, is that the people who could benefit most from this type of treatment face are often unable to access it—creating a so-called “treatment gap.” This is due to a combination of geographical, socioeconomic, and financial barriers, as well as “a lack of qualified providers who can deliver these therapies.” So, while studies may suggest that MAT can improve treatment adherence and reduce the risk of overdose, relapse, and infectious disease transmission. The reality is that if the MAT is really working, then it won’t confer these benefits to the many patients who cannot access it.
Drug Rehab Programs
Meanwhile, there is no current standard of drug rehabilitation, meaning that it can be difficult to accurately evaluate rehab programs since standardized and objective metrics are not being used. Drug rehab facilities and programs have flexible and non-homogenous criteria for “success” and therefore may not capture the severe issues of attrition and relapse.
Additionally, traditional inpatient and outpatient rehab programs often provide techniques and services that are off-putting to individuals. Blanket beliefs that everyone needs to (or would benefit from) group therapy, for instance, or even the idea that they must attend 30, 60, or 90-day programs in order to effectively “detox”—then spend the rest of their lives labeling themselves as “addicts”—has failed many, and sadly keeps many more from seeking treatment.
The global market for opioid drugs in 2018 was estimated to be a whopping $25.4 billion. A significant portion of this was allocated to replacement opioids used for de-addiction within the MAT model. Meanwhile, opioid use disorder is on the rise. Could there be a better use of our resources to address this public health crisis?
A New Model for Opioid Use Disorder Treatment
Imagine what would happen if someone—at the moment they realized they were dependent on opioids—could simply walk into their doctor’s office and ask to be detoxed?
What if individuals with opioid dependency or opioid use disorder could seek timely treatment without fear of being judged, bottle-necked, or shuttled into a drug treatment program that merely renders them dependent on a different type of the same problematic drug?
This is a question we’ve asked a lot in our treatment center. The model of care we have designed and implemented—to the direct benefit “the patient”—is our direct attempt to answer it.
Waismann Treatment™ – When Medical Science is Ahead of Its Time
At Waismann Treatment®, our experienced doctors and clinicians provide fully individualized care for people suffering from opioid use disorder. We medically detox patients based on their age, medical history, health status, poly-substance history, and even their emotional status and wishes. We offer a range of opioid detoxification protocols—including inpatient medically-assisted detox—that provide patients the best available treatment based on their specific needs and goals, instead of protocols based on judgmental views or worse, on business interest.
By successfully helping patients come off opioids, we provide our patients with a much better chance to be more emotionally available and invested in their care. This emotional presence allows an opportunity to assess and treat the real heart of the issue. What psychosocial, social, and socioeconomic factors are contributing to this person’s addiction? What do they need on an emotional and spiritual level? We seek to pull back the curtain on addiction by identifying and addressing these issues.
Our commitment to providing timely, non-judgmental, comprehensive, and customized opioid use disorder treatment has helped our patients achieve a nearly 100% success rate. It’s not because we’re better or smarter, but because we are willing to do more and see further. We want to empower the individuals and not break them down even further. Most of all, we want to help people find an effective solution to a treatable condition. We want to provide freedom from all the negative repercussions opioid use disorder can bring, including revolving rehabs, stigma, shame, and the feeling of being a slave to opioids.
If we as a small medical group can provide this type of effective approach, we believe it’s possible for other places to provide the same level of care and results. It’s time to upgrade the standard of care for opioid use disorder because individuals and the community at large stand to benefit. As a society, we already have the science and resources available to provide real solutions and allow people to have a much better quality of life free from opioid dependence—collectively, all we need are the right priorities.