There has been extensive media attention on the “opioid crisis” and how to help the millions of Americans that find themselves dependent on prescription pain killers and heroin. One focus is to decrease the number of opioid prescriptions and decrease the quantity dispensed for certain types of pain in order to eliminate the number of opioids on the street. Another focus is to increase public knowledge on treatment options available for those who have found themselves self-medicating with opioids beyond what is prescribed or who are unable to stop using opioids, even when no longer needed for pain management, and for those who are using heroin. Substance use disorders are chronic medical conditions that need to be treated as such.
Historically, inpatient detox/rehab facilities have been the mainstay treatment for addiction, but this is not a realistic option for everyone, financially or otherwise. There are several outpatient treatments available with increasingly positive results. Methadone is frequently used to treat opioid addiction, but requires an individual to physically go to a certified methadone treatment facility on a daily basis to receive their medication. This can often pose a problem for patients in a rural setting, those without transportation, or those with a job that does not allow for daily visits.
More recently, buprenorphine, alone or in combination with naltrexone, is being effectively used to treat opioid addiction. Buprenorphine comes in several forms, usually a tablet or a film that dissolves under the tongue. Vivitrol, an injectable naltrexone, is also frequently used to help relieve cravings without the risk of physical dependence. Medication-assisted treatment (MAT) is usually provided by a clinician with specialized training in treating addiction in an outpatient setting. Medication is usually prescribed for a week or a month at a time, and addiction counseling should be included as a standard part of treatment. Treatment in an outpatient setting is beneficial for those with a strong support system, and patients are often able to continue working.