Opioids are a collective group of drugs including opium, morphine, codeine, heroin, and hundreds of prescription opiate derivatives and synthetic opioids used in treatments for pain. For an individual dependent on opioids, one of the biggest fears and a primary reason they continue to use is the negative conditions of withdrawals they go through, sometimes multiple times each day. The longer the dependency lasts, the more difficult it becomes to manage the powerful and brutal withdrawal symptoms despite the willingness to quit and going cold turkey just doesn’t work for the majority of individuals to be able to maintain any long-term stability in abstinence.
According to the Substance Abuse and Mental Health Services Administration, “The longer you’ve been dependent on opioids, the more likely it is that you would benefit from being on methadone.” Methadone, itself, is an opioid agonist drug that works similar to these opioids to reduce the cravings and physical withdrawals as the dependency to the shorter-acting opioids is reduced. The great thing about methadone, despite ongoing stigma, is that it can be used safely in combination with counseling, psychotherapy, and other interventions in methadone maintenance programs to actually give opioid dependents the chance to improve their lives. The following are some benefits of methadone maintenance over going cold turkey.
According to the SAMHSA, “Methadone is up to 80 percent orally bio-available, and its elimination half-life ranges from 24 to 36 hours. When methadone is administered daily in steady oral doses, its level in blood should maintain a 24-hour asymptomatic state, without episodes of overmedication or withdrawal. ”
Reduction in harm is a primary goal of methadone maintenance and a major benefit over going cold turkey. Reductions in crime, intravenous use of opioids, spread of communicable diseases, infections, and overdoses both fatal and non-fatal are some of the most common concerns.
The DEA reports that “Because heroin abusers do not know the actual strength of the drug or its true contents, they are at a high risk of overdose or death” and theCDC reports that,” Of the 22,767 deaths relating to prescription drug overdose in 2013, 16,235 (71.3%) involved opioid painkillers” Nearly every opioid dependent will relapse after attempting detox without treatment help. Most will go through multiple episodes of detox and relapse before they give up or seek treatment and the problem with this is that every time they decrease their tolerance during the detox phase, they increase their risks of overdose every time they relapse.
Opioid Relapse Prevention
The National Institutes of Health (NIH) states that “The major problem in the treatment of opioid dependence still remains the occurrence of relapse, to which stressful life events, renewed use of heroin, and exposure to drug-associated environmental cues are all positively correlated.” What this means is that, even if the person manages to get through the physical turmoil of pain and other adverse conditions of opioid withdrawal, they are still left with some powerful residual effects that can go on indefinitely if not properly addressed.
Methadone maintenance is more than a daily dose of methadone that works to control cravings and stabilize physiological processes to deter illicit opioid abuse. It helps the person achieve a self-directed, healthier, and more productive lifestyle by addressing the issues that these people need to be able to function in their homes, at work, and in society with levels of confidence, capabilities, and integrity that promotes stability in abstinence.
Improved Quality of Life
Going cold turkey may be perceived as a show of strength and willpower to quit using opioids, but, until there are major lifestyle changes to improve overall health and social functioning, recovery is slow and painful. At some point, the struggles to remain abstinent will probably become a stumbling block of confusion, misguided efforts, and overwhelming despair to the point that it all seems worthless.
According to an article published by the Mt Sinai Journal of Medicine in the U.S National Library of Medicine “Reviews issued by the Institute of Medicine and the National Institutes of Health have defined narcotic addiction as a chronic medical disorder and have claimed that methadone maintenance coupled with social services is the most effective treatment for this condition.” In addition to methadone dispensing, the quality of life for an opioid dependent can be improved in methadone maintenance programs through the following services:
- Comprehensive recovery support referrals and services
- Identifying and addressing co-occurring mental health and poly-substance abuse disorders
- Counseling and behavioral therapies (identification of problematic areas and strategies to promote wellness and recovery)
- Interventions to address family problems
- Medical interventions including tuberculosis, HIV, and hepatitis C virus (HCV) testing, education, counseling, and referrals and integrating care for other medical issues.
- Psychosocial assessments and referrals for additional services such as vocational, housing, legal, transportation, or financial assistance as needed.
Another significant benefit of methadone maintenance over going cold turkey is that it gives the individual the time they need to recover from opioid dependency without any time restrictions. Treatment retention affords a methadone maintenance patient the opportunities to take advantage of the program services and progress in their recovery goals more effectively. Some people remain in these programs indefinitely.