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Some Treatment Makes It Harder to Recover

Marcel Gemme By Marcel Gemme | Last Updated: 19 September 2023
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An undiscussed problem in addiction treatment

There’s a problem with addiction treatment that no one’s talking about. It’s that we’re making it harder and harder for people to get off drugs.

Although recent studies show a decrease rate in overdose deaths, opioid addiction is at an all-time high. This isn’t a gauge of treatment effectiveness because not everyone who suffers from addiction receives treatment. The only way to measure the effectiveness of treatment is by comparing relapse and remission rates, and this would need to be done over an agreeable period. One would first decide what was considered “success” and whether this was measured by lifelong abstinence or another agreed-upon duration of time. This factor would dictate the necessary length of study to paint an accurate picture.

Several other factors make this a complex problem. There are multitudes of different forms of treatment available. Many of these are challenging to study, and outcome monitoring systems aren’t in place to accurately determine success. Anonymity is yet another barrier. Basically, there’s no status quo, so we’re left comparing apples to oranges with no real way of keeping track of them. ¬

Ax examination of Medically Assisted Treatment

But what’s amazing is that the new medically backed model, Medically Assisted Treatment or MAT, disregards solving these variables. Studies have been published and interpreted to show that it’s reducing rates of treatment recidivism and post-treatment relapse. Considering the lack of long-term research, inherent flaws in logic are being overlooked in these interpretations. Yet the therapy is being resoundingly cited as fact-based.

Most notable of these flaws is that a treatment where a person is being given an addictive medication cannot be accurately compared to an abstinence-based model in order to prove retention. Certainly, one would be less likely to leave a situation where they are given a drug that prevents opioid withdrawal syndrome. The person leaving an abstinence-based model would experience no direct worsening of symptoms, whereas the MAT patient would. That’s a simple risk vs. reward problem which the addict is already familiar with. But even more importantly, just because the MAT patients stay more, doesn’t mean they’re gaining anything of value. The argument of effectiveness simply because more people stay with the treatment means nothing when they’re possibly staying just to continue taking the drugs.

Secondly, the claims around post-treatment relapse are invalid due to a few factors. In MAT therapy, one is only considered relapsed if they go back to using their illicit drug of choice. Again, taking a chemically equivalent medication reduces this for obvious reasons. But further, the abstinence-based group would be forced to measure relapse in different terms, as taking anything would constitute such an event. Included in this would be taking any of the drugs that are used for MAT therapy. This also fails to account for people who seek treatment for addiction to the exact same drugs as are given in MAT, which occurs often. Finally, MAT is often lifelong, so there’s technically no post-treatment period even after person has been discharged from a treatment center. They are still receiving MAT drugs, so they are still in “treatment.”

Dependence vs. Addiction

Finally, let’s not ignore the distinction between dependence and addiction. Dependence occurs in anyone who takes opioids long term, yet not everyone becomes addicted. But the use of opioids to treat opioid addiction only furthers dependence, while psychologically solidifying the mental mechanism of drugs being the “answer.” This is the addiction component, which is left completely untreated in MAT. While MAT studies claim an increased willingness in patients to receive treatment this is likely only a comfort factor to avoid withdrawal. In the long run, it’s only making everything harder should the person ever want to become completely drug-free.




More Information

Marcel Gemme has been helping people struggling with addiction for over 19 years. He first started as an intake counselor for a drug rehabilitation center in 2000. During his 5 years as an intake counselor, he helped many addicts get the treatment they needed. He also dealt with the families and friends of those people; he saw first-hand how much strain addiction puts on a family and how it can tear relationships apart. With drug and alcohol problems constantly on the rise in the United States and Canada, he decided to use the Internet as a way to educate and help many more people in both those countries. This was 15 years ago. Since then, Marcel has built two of the largest websites in the U.S. and Canada which reach and help millions of people each year. He is an author and a leader in the field of drug and alcohol addiction. His main focus is threefold: education, prevention and rehabilitation. To this day, he still strives to be at the forefront of technology in order to help more and more people. He is a Licensed Drug and Alcohol Treatment Specialist graduate with Honours of Stratford Career Institute. Marcel has also received a certificate from Harvard for completing a course entitled The Opioid Crisis in America and a certificate from The University of Adelaide for completing a course entitled AddictionX: Managing Addiction: A Framework for Succesful Treatment.