Medication-Assisted Treatment

I can’t believe there’s still controversy over medication-assisted treatment when dealing with addiction, but there is. The argument against medication-assisted treatment has to do with the idea of using drugs to treat addiction to drugs. On the face of it, it does sound like a contradictory practice.

The critics of medication use in the treatment of addiction also claim that detox/maintenance medication interferes with recovery progress because the client is not fully in touch with their emotions.

The issue is more complicated than taking a side — medication-assistance or no medication assistance — addiction or abstinence — feeling and recovery or no feelings and no real recovery. If a physician is assisting someone in recovery, they should know about addiction and recovery. If the physician or psychiatrist understands addiction, then they’ll use medication assistance only when it’s deemed therapeutic to an individual’s treatment — the operative word is individual.

Not all clients are in need of medication assistance, but some clients might suffer from anxiety and depression and need medication assistance in order to stay in recovery long enough to make the necessary changes. Emotions, when they are painful emotions related to debilitating anxiety or depression caused by a brain chemical abnormality, are not conducive to recovery. Telling a client to suffer through debilitating anxiety in order to have a “pure” recovery is not helpful. It’s best if the client can use a medication to alleviate the painful anxiety or depression so they can concentrate on recovery and change. Maybe down the road, the client can stop the medication after their brain has healed in recovery.

When I first started in the addiction treatment field, the use of medication to help people in recovery was frowned upon, but I counseled a lot of clients who couldn’t make it because they couldn’t get through the anxiety or depression from a natural lack of brain chemicals or years of alcohol damage to the brain, or the awful withdrawals from opiates.

The point is that treatment is individualized, and each client has different needs, even if many principles of recovery are the same for everyone. Understanding a client’s individual needs entails a thorough evaluation up-front. Medication, in and of itself, is not bad. If we believe in the disease concept of addiction, then the use of medication to assist in treatment of addiction is no different than medication used in the treatment of other medical conditions. It’s up to medical professionals to understand addiction and to know what medications truly assist a person into recovery, and which medications are counterproductive.