No, medication-assisted treatment is absolutely not substituting one addiction for another.

People may view addiction medication this way because some MAT medications are opioid-based. People who take them are physically dependent on them and will experience withdrawal symptoms if they discontinue use. An important point to remember is that there is a huge difference between physical dependence on a medication that helps a person live a normal, healthy life and addiction to a harmful drug that diminishes a person’s health and well-being and carries a high risk of criminal justice involvement or death.

Addiction medications are fundamentally different from short-acting opioids such as heroin and prescription painkillers. The latter go right to the brain and narcotize the individual, causing sedation and the euphoria known as a “high.” In contrast, addiction medications like methadone and buprenorphine, when properly prescribed, reduce drug cravings and prevent relapse without causing a “high.”

All three FDA-approved medications can help patients disengage from drug-seeking and crime and become more receptive to behavioral treatments. One of the three, Vivitrol, blocks the brain’s opioid receptors and does not cause physical dependence at all.

Why do you think the public looks at methadone treatment programs negatively?

I’d like to amend the premise. While there are certainly members of the public who view methadone negatively, there are also substantial numbers of people who understand the decades of science proving the effectiveness of methadone maintenance therapy. Unfortunately, too many people have seen firsthand the devastation that opioid addiction can cause, but they have also seen the chance for recovery that methadone and other medications can offer.

With respect to the negative perceptions out there, to the extent people believe that methadone is substituting one drug for another, they may view methadone treatment programs as part of the problem, not the solution. People who hold these views are likely unfamiliar with the science behind methadone and other medications. For example, many do not know that continuous methadone maintenance therapy has been associated with drops in heroin use of over 80%.

Even supportive members of the public often do not realize that methadone programs are subject to extensive regulations that require them to monitor their patients for illicit drug use and provide them counseling and support services. A lot of people may be surprised to learn that many people who attend methadone programs are successful parents and employees. They go straight from their program to their jobs, where no one even knows that they are in recovery from opioid addiction.

How can this opinion be turned around?

More people need to be exposed to the overwhelming evidence supporting the effectiveness and safety of methadone and other medications, the heart-wrenching stories of friends, family members, and neighbors lost to the scourge of opioid addiction, and the incredible stories of lives restored by these powerful treatments. We are losing about 100 people a day to opioid overdoses in our country, more than die in traffic crashes, and these medications can significantly reduce those numbers. When people know that, it’s hard to argue with.

PAUL SAMUELS, LAC