Today in the US, overdoses account for more deaths than car crashes. The frightening reality of opioid relapse is that death is a very likely outcome. Unlike relapsing on alcohol and waking up with a hangover the next day, after relapsing on drugs such as heroin and painkillers after a period of time clean, you many don’t wake up at all. As opiate addicts get sober and stop using opiate drugs, their bodies begin to lose the ability to tolerate the drugs. Many people think they can go back to using as much as they did before they got clean, their bodies can’t handle it, and if often leads to overdose and death. What once was a moderate dose for the addict may now be enough to prevent the brain from signaling the body to keep breathing. The next troubling truth for opioid abusers is that even after successful treatment few are able to remain continuously abstinent during the first year of recovery. A few studies have put the number at a low 14% that make it through the first year without any slips, or full blown relapse episodes. Getting sober is possible, it’s just the first year that is crucial, and most have at least one slip, and with opiates one slip is all it takes to lose your life.
Turning to medication has become increasingly popular and beneficial to those suffering from opioid addiction, and unable to attain long-term sobriety. Many treatment programs are sending clients home from opioid treatment with Naloxone, or Narcan; the latest self-administered opioid antidote. This is great in emergency situations, and has been saving thousands of lives across the country; the real focus however should be preventing the possibility of overdose all together. The best way to do this is to identify those at the greatest risk of relapsing, and make sure they have all the possible tools at their disposal, including medication-assisted treatment (MAT). We have discussed these medications in previous blog posts, outlined the pros and cons, and highlighted the risks. There is Naltrexone injections, or buprenorphine, both have shown to make relapse less likely, although they are not a forever plan, they can help secure sobriety for at least the first year or longer. Vivitrol is probably the most secure of the MAT drugs, is not addictive, and does not cause any highs. It is injected and lasts up to a month so the addict does not have to think about taking a pill or missing a dose, they are protected for a longer period of time.
When predicting whether or not you or someone you love would benefit from medication assisted treatment there are a few things to consider. If one or more of these factors pertain to you or your loved one, you may be a good candidate for MAT:
- A previous overdose, particularly in the past 6 months
- Intense cravings
- A history of using cocaine in addition to opioid drugs; cocaine increases impulsivity, and MAT drugs so not prevent a high from cocaine
- A history of participating in IV drug use
- A reluctance to embrace the changes recovery requires
- A history of criminal behavior beyond drug use