Let's talk about Opioid Use Disorder (OUD) and Medication Assisted Treatment (MAT). You have questions, we have answers.
Are opioids really a problem in rural Colorado?
30-40 people in eastern Colorado die each year from an overdose.
55% of prescription opioids that are abused were obtained free from a family member or friend.
Another 12% are purchased from a friend.
What are Opioids?
"Opioids" are pain medications. Sometimes they're also called "prescription pain killers" or "pain pills."
Opioids go by lots of names. Brand names like Demerol, Dilaudid, Norco, OxyContin, Percocet, or Vicodin. Or maybe you recognize the generic names of opioids, like fentanyl, methadone, or hydrochloride. Opioids also go by street names: Pancakes & Syrup, Miss Emma, Monkey, Demmies, China girl, Goodfella, Tango and Cash, Oxy 80, Hillbilly heroin, Perks, Juice, and Dillies.
Opioids include prescription pain medicine (vicodin, oxycontin, etc.) and heroin.
What is Opioid Use Disorder (OUD)?
"Opioid Use Disorder" is another way of saying opioid addiction, that someone has an addiction to opioids, or is misusing opioid pain medicine and is at high risk of becoming addicted.
Withdrawl short-circuits the brain’s logic and reasoning center (the prefrontal cortex). The brain is incapable of performaing any task not in the service of drug use. This is the loss of executive function and results in “insentive salience” which has been defined as “a wanting with oomph”. More than just a desire, this is a true compulsion to use.
Addiction hijacks the brain. For some people they really cannot reason through this stage.
Once addicted, a person begins to use NOT to get high – but to feel normal. Over time, a person begins to feel withdrawal symptoms if they do not use the drug (fever, sweats). Think about tolerance and dependence. A person needs more of the drug to feel the same effect (tolerance). Without it, they feel lousy (dependence). And we mean LOUSY.
What is Medication Assisted Treatment (MAT)?
“Medication Assisted Treatment” is a treatment plan that can help you overcome addiction to opioids. MAT has important features:
- MAT is not a 30-day residential treatment. You receive MAT as an out-patient.
- MAT includes medication to decrease craving and withdrawal.
- MAT is not just a drug. It includes long term support, including monitoring, counseling, and maintenance.
- MAT may include community groups such as 12-step programs, faith communities, group counseling, sober living housing and sober living clubs and activities.
- MAT includes your family, friends, and loved ones.
- People start MAT with medication to help stop the suffering from withdrawal.
Where can you get Medication Assisted Treatment?
Historically, only certified Addiction Treatment Centers could treat opioid addiction. There are only a few certified addiction treatment centers in Colorado.
Drug Addiction Treatment Act of 2000 allows a primary care provider (doctors, nurse practitioners, and physician assistants) with special training to treat patients with opioid use disorder.
Primary care practices in eastern Colorado, the San Luis Valley, and all over Colorado are receiving training specifically to help with opioid addiction/dependence. They are being trained in MAT for opioid use disorder. Maybe your doctor has received training. Maybe your practice provides MAT for OUD. Maybe you can get medication assisted treatment in your community.
Search for a MAT prescriber near you using the SAMHSA Buprenorphine Treatment Practitioner Locator.
Buprenorphine is an evidence-based, thoroughly studied, effective treatment for OUD.
- 80-90% of people addicted to opioid pain medicines will relapse without MAT
- Buprenorphine increases treatment retention, giving patients time to get behavioral health counseling, employment, and reengage with their life.
- MAT leads to an 80% decrease in illegal drug use and crime.
- MAT leads to a 70% decrease in death from any cause over the first year of treatment.
Buprenorphine MAT is available in local primary care practices.
How buprenorphine works:
- Buprenorphine is a chemical that tightly bonds to the mu receptor, but does not fully activate it (the mu receptor). An agonist “activates” the mu receptor. Opioids are agonists and activate the receptors. Buprenorphine is a partial agonist – it does not fully activate the mu receptor. So there is a very little euphoria. Buprenorphine does not trigger the whole cascade of sedation, euphoria, etc. Buprenorphine does not hi-jack the brain.
- Buprenorphine attaches to the mu receptor (the same place opioids attach). Buprenorphine doesn’t really make you high, but it does keep you from going into withdrawal. And it blocks the receptor so no other opioid pain medicines (vicodin, oxycontin, heroin) can attach to the receptor.
- Burprenorphine attaches tightly on that receptor, not allowing other opioids to come in and activate the mu receptor. Sort of like a big dog blocking the doorway.
- Buprenorphine has a long half-life. That means it sticks around the body and attaches to that mu receptor for a long time. This is one of the factors that makes it ideal for opioid treatment.
- Buprenorphine is a chemical that attaches to the Mu receptor in your brain – the same place opioids attach. Like a dog blocking the doorway, Buprenorphine blocks other opioids from attaching to the Mu receptor. Buprenorphine does not make you high – but it keeps you from going into withdrawal. It sticks around in the body for a long time.
Talk to your primary care provider TODAY about treatment options for opioid use disorder, including buprenorphine.
Addiction is a disease. Take control of your health and get your life back.