Medication Assisted Treatment For Opioid Addiction: A New Perspective

When Americans are asked to recognize U.S. service members, law enforcement and first responders, the feelings of reverence honoring those men and women are of unity and appreciation. The recognition that these heroes sacrifice their safeties in daily battles is generally met with gratitude and celebration.

But these heroes are fighting even after their life on the battlefield has ended. The opioid battlefield at home is far greater a foe, claiming its victims in numbers that greatly surpasses any battlefield - domestic or overseas.

According to the U.S. Department of Veterans Affairs, veterans and service members of all ages are increasingly afflicted with opioid use disorder (OUD), are ten times more likely than the general public to abuse opioids and twice as likely to overdose.

About a third of opioid abuse among service members and veterans could be explained by a war injury, with one-in-four troops having been prescribed an opioid medication in a given year at hospital discharge (with rates decreasing according to the Military Health System), and a quarter continued to take them for a prolonged period of time following their releases. This self-medication leads to opioid abuse as the prescriptions run out, causing patients to turn to sedatives and tranquilizers for non-medical purposes, or pairing opioids like heroin and fentanyl together with drugs like benzodiazepines.

Addressing this epidemic as it relates to the military community comes with a unique level of navigation, to include the self-imposed stigma service members face when they seek help within their own community. With the added concern that clients may regress during this unprecedented time of physical and social distancing, the team at Warriors Heart - a private treatment facility providing care for addiction and chemical dependency & PTSD for active military, veterans and first responders - recognize that those living with SUD, OUD, PTSD and MTBI suffer from a disease of isolation.

“One of the biggest apprehensions in entering any addiction treatment, is the fear of experiencing withdrawal symptoms,” stated Warriors Heart Co-Founder, Tom Spooner. “It’s a valid concern, and one we at Warriors Heart don’t take lightly - because depending on the length and level of abuse, those withdrawal symptoms can be incredibly painful. Certain drugs can make the detox process much more raw, based on their side-effects to the body.”

Another concern is learning how to navigate cravings once sober. Once individuals complete the detox phase, many treatment facilities have turned to long term medication-assisted treatment (MAT) in an attempt to help fight off cravings and remain abstinent. These programs are federally funded, and use FDA- approved medications to treat opioid addiction and alcohol dependence by relieving the withdrawal symptoms and cravings that result from chemical imbalances. MAT has the goal of keeping the body and brain chemistry balanced through controlled level of medication(s) to help the person overcome the use opioids.

In some cases, methadone is used help to avoid relapse; working as a long-acting opioid, filling the same opioid receptors in the brain that heroin and prescription painkillers do. As a result, patients experience the intense withdrawal symptoms associated with heroin use. While this can allow those in treatment to fully focus on therapy versus the discomfort of detox, this process merely masks the original problem by maintaining the body’s craving for a prolonged time. Methadone and Suboxone, two of the more commonly prescribed medications during MAT, were not originally designed for long-term use - yet the number of individuals using these particular medications is increasing.  Facilities such as Warriors Heart, seek to identify the root of the addiction, and navigate its detachment, the successes in limiting the number of warriors who need long term MAT.

MAT is not a, “one-size-fits-all.”  While many insurance companies and VA's are steering towards MAT for those addicted to Opiates, each individual requires individual evaluation and care, catered to what is best for them.  In some instances, the insurance companies or financial support systems want to dictate treatment, despite their absence from the individuals’ evaluations and proposed treatment.

Currently, many VA’s use MAT as a first right of refusal for patience coming in, seeking care for their SUD. If a patient wishes to have a medication-free process, it must be verbally requested at the time of consultation – therefore guiding many of those in their most vulnerable state, blindly into a process that could ultimately lead to risks exceeding benefits through the recovery process.

“While MAT is a more expeditious way to help someone through detox, it is not designed to deal with the existing psychological, social and behavioral issues that led to the individuals’ original substance abuse issue,” stated Spooner. “Detox services for our military community have oftentimes neglected levels of addiction intensity within these individuals - such as the need for inpatient, partial hospitalization and outpatient care. People struggling with an addiction should be placed in the appropriate setting according to their needs; and many of these individuals wish to seek treatment without any additional chemical admissions.”

Addiction doesn’t discriminate, nor does it wait for “the right time” for an addict to decide to get help, which involves a complete substance abuse treatment program for successful and long-lasting sobriety. While the team at Warriors Heart have seen successful treatments with MAT, and use MAT in short term, especially in the detox process, the goal is to have warriors free of any mind altering substances in order to reach the raw, true emotions, and get to the heart of the matter.  Truly focusing on each individual and what his or her particular assessment and needs require.

Both the Departments of Defense and Veterans Affairs have launched campaigns to curb opioid prescriptions and are conducting research to understand the scope of the problem within the military and veteran populations.

While coupled with individual therapy, medications and other interventions, many people rely solely on groups once the detox phase of treatment has ended. Over 23 million Americans experience a substance use disorder (SUD), among whom only 10% access treatment.

“As addicts, we are looking for the quick fix, the easy way out,” stated a Warriors Heart Alumnus.  “We would seek to find that solution, albeit only temporary, at the bottom of a whiskey bottle or pill bottle.  At Warrior’s Heart we are taught and guided through the twelve-step program of recovery; given tools, rather than drugs to combat our addiction and PTSD.  As members of the Warriors community, one thing we love to do is work.  We overcame many challenges in our lives to earn that title of “Warrior.”  The same applies in our recovery program at Warrior’s Heart - we work at it, both physically and mentally. No pill or injection can give you that connection with a higher power.  No pill or injection can give you gratitude.  No pill or injection can grant you the serenity to accept the things that you cannot change, give you the courage to change the things that you can and give you the wisdom to know the difference.  No pill or injection can give you your life back.”

At Warriors Heart, the Detox Center is fully staffed with licensed and experienced alcoholism addiction specialists who provide personalized monitoring and management of withdrawal symptoms around the clock. Each individualized detox program is designed to provide the highest quality treatment for overall wellness and recovery.

Across the country, treatment centers, like Warriors Heart, remain ready and available to provide the treatment to their clients in overcoming substance abuse.

If you need more information or help with your treatment, or help a loved one, contact one of our Admission Advocates anytime, 24/7 at 1-844-958-1183.