Heroin addicts in the U.S. are falling through the cracks of the treatment programs that are reliant on methadone.
Every couple of days, a post shared by one of my friends will catch my eye, “Shoot your local heroin dealer.” It happens a lot, and I see why as I watch the news. The Center for Disease Control reports that deaths caused by opioid overdose have increased from 1,960 in 1999 to 12,989 in 2015.
The more people that overdose from opioids, the more it shows that the treatment is coming up short. For recovery, an addict can go to a Methadone Assisted Treatment Center (MAT). MAT aims to help the addict maintain themselves and is not considered a cure for opioid addiction.
The addict has to have already gone through detox and entrance counseling to learn about the effects of methadone. The addict is then given a dose every day. The idea is to stop the addict’s physical and mental withdraw. The first two weeks of the program shows the highest rate of relapse.
Graphic by Samantha Moore / Art Director, photo illustration by Adam Urquhart / Opinions Editor
European nations have attempted a different program called Heroin Assisted Treatment (HAT). This program uses pharmaceutical grade heroin in lure of methadone. This controversial treatment is only used for those who have fallen out of a MAT program during the critical two-week period.
Research done in a study published in the peer reviewed journal Addiction titled Matching of treatment-resistant heroin-dependent patients to medical prescription of heroin or oral methadone treatment: results from two randomized controlled trials published demonstrated that participants receiving HAT responded better to treatment than those in a methadone treatment. The response rate was 23.1 percent higher for HAT than Methadone based treatment. The limitation in this and other studies is that the researchers don’t account for behavioral therapy.
To better understand why using just methadone or heroin assisted treatment is not enough, let’s look at the common issue of depression. In both addiction and depression, medication is given. The depressive patient is given a drug that helps them handle the ups and downs of depression. To help move the client along, they go and see a counselor. The counselor helps give the person the tools needed to overcome depression without the use of medication. Over time, the person is taken off of the medication.
If we use this same model for addiction, then after the person is given methadone, they also need to have behavioral therapy to deal with the behaviors that outline their addiction.
Prescribing heroin as opposed to methadone has shown that it will help those who do not respond to methadone treatment. With supervision the treatment has the ability to get the extremely dependent addict to place of normalcy.
This can be seen by the 20 percent difference between those in HAT and those in a Methadone program. 23.1 percent may not seem like a big difference but when compared to the previous response rate 28 percent it is , I believe that implementing behavioral therapy alongside medication will benefit the addict as it benefits the depressive person.
The question now is not if should we use HAT, but when are we going to use HAT. Something has to be done so our addicted population gets the help they need. This includes both chemical intervention as well as behavioral intervention. Until the combination of both are met, people will continue to fall out of the one-sided treatment facilities.
Dyllin Bates can be contacted at dbates@kscequinox.com
