On the other side, the 12‑step‑oriented model of addiction treatment needs to add medication as a fully respected, long-term option for patients with opioid use disorder. That is a huge step for them to take. Not all OUD patients will choose MAT, but having it available to them is in the patients' interests.
The Hazelden Betty Ford Foundation is pioneering this new hybrid approach. When people go into the HBF program, if they have problems with opioids, they are actively encouraged to use medications as part of this 12-step recovery-oriented system of care.
My goal is to help our two treatment camps to stop fighting with each other and to work together in mutual respect. Reach out your hand to the other folks and bring them in with you – into what you're doing. We are dealing with one disease involving many different drugs. Millions of addicted people need help. There is no one right way. There are many different paths to sustained recovery that need to work together to achieve the goals that none alone can achieve.
(“M.A.T. can be a helpful ‘circuit breaker’ in some contexts, but can never be an end in themselves, as long-term use of any toxin only aids and abets harms. ‘Sunset Clauses’ on M.A.T use can really only work with a drug use exiting therapeutic tool, such as 12 Step Programs simultaneously in play.” – Dalgarno Institute_
Background: Alcohol and other drug (AOD) problems confer a global, prodigious burden of disease, disability, and premature mortality. Even so, little is known regarding how, and by what means, individuals successfully resolve AOD problems. Greater knowledge would inform policy and guide service provision.
Method: Probability-based survey of US adult population estimating: 1) AOD problem resolution prevalence; 2) lifetime use of “assisted” (i.e., treatment/medication, recovery services/mutual help) vs. “unassisted” resolution pathways; 3) correlates of assisted pathway use. Participants (response = 63.4% of 39,809) responding “yes” to, “Did you use to have a problem with alcohol or drugs but no longer do?” assessed on substance use, clinical histories, problem resolution.
Conclusions: Tens of millions of Americans have successfully resolved an AOD problem using a variety of traditional and non-traditional means. Findings suggest a need for a broadening of the menu of self-change and community-based options that can facilitate and support long-term AOD problem resolution.
Cannabis Use Is Associated With Suicidal Ideation Among Individuals With Opioid Use Disorder Receiving Opioid Agonist Therapy: Cannabis use is associated with suicidal behavior in the general population. This Canadian study investigated the association between cannabis use and suicidal ideation in cohort of participants aged 16 or older with opioid use disorder who were receiving opioid agonist therapy. This study raises concerns about the potential effect of cannabis on the psychological health of individuals with opioid use disorder.
Apr 13, 2021, Conor Gallagher
There are about 10,000 people on Methadone Maintenance Therapy in Ireland. Photograph: iStock
Methadone users who wish to become drug free are being discouraged by doctors, who are often more interested in increasing patients’ doses, a new study claims. Those prescribed methadone to help them stay off heroin describe themselves as “lifers” bound in “liquid handcuffs” which prevents them from becoming drug-free.
According to the study, which was carried out by Trinity College academics and published in the International Journal of Drug Policy, users view methadone as a “ball and chain” and doctors rarely assist in helping patients come off the drug. “Those who aspired to reducing their daily methadone dose or becoming drug free reported not merely that they were not assisted in striving towards these goals, but that clinicians did not permit them to discuss such an aspiration,” authors Paula Mayock and Shane Butler wrote.
The authors conducted in-depth interviews with 25 long-term recipients of Methadone Maintenance Therapy (MMT), 16 of whom had been on methadone for more than 20 years. Indefinite MMT, along with needle exchanges and other harm reduction initiatives, was introduced in Ireland in the late 1980s to combat the heroin epidemic which had taken hold in urban areas. There are about 10,000 people on MMT in Ireland, including a large portion who have been taking the drug for many years. Although recent drug policy documents use language such as “pathways” and “progression” to a drug-free lifestyle, many MMT recipients who took part in the study felt methadone left them “trapped in a cycle that did not lead to progress or change”.
‘Held hostage’ - The majority of participants felt MMT had a positive impact on their lives in at least one respect, including increased stability, the opportunity to rebuild family relationships and less contact with the criminal justice system as they did not have to steal to feed their addiction.
But this was almost always juxtaposed with the feeling that MMT prevented users from moving forward. One of the participants, identified as Dillon, said MMT stalled but did not fix the problem. “It’s only just keeping it at a certain stage, it’s not getting any better, you know what I mean. I just feel like [methadone] is holding everyone.”
The Dalgarno Institute has long advocated for
Conclusions: Most individuals achieve an increasing number of achievements with time since AOD problem resolution, and these are associated with gains in measures of well-being that may support ongoing AOD problem remission, and recovery.