Since the advent of methadone, medication assisted treatment has been the subject of much scrutiny. Although progress continues to be made with the use of medication to treat alcohol and opioid dependence, many questions still remain. Research has confirmed the effectiveness of such medications in combination with a comprehensive treatment program, but many people in recovery and the field of substance abuse continue to be wary. Medication assisted treatment is in the forefront of addiction and recovery discussion. Much controversy has surrounded the topic of this type of treatment being a “cure” or a “crutch.”
The “cure” portion of the debate refers to whether or not medication assisted treatment manages addiction to the point of stabilizing a person to “normal” living while minimizing the risk of relapse. Often, individuals begin medication assisted treatment under the assumption that they will be cured. Moreover, beliefs from their support systems contribute to this assumption and create high expectations for success with the use of medication assisted treatment. Medications used to treat alcohol and opioid dependence essentially satisfy the brain’s desire for the drug by eliminating the physical withdrawal symptoms associated with treatment and recovery. The elimination of the physical symptoms can help facilitate recovery for those impeded by the physical withdrawal. Although the physical desire is quelled, the mental desire may still remain, thus dispelling the “cure” debate. The absence of withdrawal symptoms can make the transition to recovery easier, but cannot effectively cure addiction.
The belief of medication assisted treatment as a “crutch” is also commonly held. This viewpoint considers the use of medication for addiction treatment as an easy way out by simply relying on another substance. It is common for some individuals using medication assisted treatment to take the medication in lieu of their drug of choice and not really embrace recovery. In this situation the individual is using the medication as a crutch as they are not making the necessary changes in their life. Also, many people in the recovery community view utilizing medication assisted treatment as “using.” Because complete abstinence is commonly viewed as the only true way to recover from addiction, people using medication assisted treatment are not considered to be in recovery.
Perception is everything in this debate. Nevertheless, medication assisted treatment should not be considered either a cure or crutch, but in fact a tool. Medication is not the solution, but it can be an integral part of someone’s treatment plan to aid in their recovery while they detox from the physical symptoms of withdrawal. Beyond withdrawal, treatment that utilizes medication assistance will continue to be a hot topic of debate that has yet to offer a definitive consensus.
SAMHSA: Pharmacotherapy for Substance Use Disorders