Can drug replacement therapy actually help patients recover from addiction?

While it is known to be a controversial issue in the addiction recovery community, it’s beneficial to have a complete understanding of all sides of the discussion. That way you can make your own informed decision.

drug replacement therapy woman

What are the principles behind Drug Replacement Therapy?

Often referred to as DRT, it serves as a form of long-term substance abuse recovery maintenance. The most common example is Methadone, which is prescribed by a physician for patients struggling with opioid addiction. The patient receives their medication by visiting a clinic every morning. Another commonly prescribed example of DRT is Suboxone, which is also used for opioid dependency. These medications replace the patient’s need for the drug, and also help with some of the physical effects of addiction and withdrawal, however it is technically the exchange of one substance for another, which some is not the right choice for some patients.

Nevertheless, here are some benefits:

  • Removal of a criminal element. When given the option to use a legal substance instead of heroin, oxycodone, or another illegally obtained drug, the user has been given a chance to gain control over their habit. Stealing, begging or doing any kind of illegal activity to chase that high they crave have all become part of a cycle, or series of habits that now define the addict’s entire lifestyle. By removing some of these elements, we can help the user to begin to create change.
  • Focus on the person. Starting the path to recovery through drug replacement therapy can help the user to begin to focus upon themselves, and raise their sense of self-worth once again. Many drug users have been through some form of abuse or tragedy, and have developed their addiction as a way to cope or ignore their emotions. Beginning even one small step towards change is evidence to both the user themselves, as well as anyone else with whom they choose to share this information, that they are investing in their health and future.
  • It can lead to change. Many users who have started drug replacement therapy have later decided that they were ready to begin inpatient treatment to further their recovery and ensure long-term, lasting sobriety. As stated, one small step towards change can lead to more productive results over time.

What are the difference between suboxone and methadone?

Another prevailing controversy regarding drug replacement therapy concerns the possibility of health effects related to long-term methadone or Suboxone use. Both medications are classified as synthetic opioids. Methadone is a full opiate agonist, whereas Suboxone is only a partial opiate agonist. This means that even if a patient was to take a large dose of Suboxone, the opioid-type effects would be limited. Following you will find expanded details regarding the differences between the two medications, as well as expected physical effects with consistent use:

  • Suboxone is more difficult to abuse, but it is available via prescription from your physician, and can be filled at your local pharmacy. You are permitted to take it home and administer it at your discretion. In contrast – due to its higher potential for abuse – in order to receive Methadone treatment, a patient must travel to the clinic each day for their medication.
  • Many addicts struggling with the most serious opiate addictions will report that Suboxone is not as effective at relieving their withdrawal symptoms and that they would rather take methadone. Methadone is much stronger and tends to works more quickly than Suboxone.
  • Methadone can be much more addictive than Suboxone. A fatal overdose can happen with methadone, but with suboxone this is a rare occurrence.
  • Methadone’s active ingredient is the same as the brand name itself and Suboxone is a combination of buprenorphine and naloxone.
  • Suboxone is much more expensive than methadone. Methadone is available in generic formulations, but Suboxone is a newer drug which is currently available by brand name only.

Two varying opinions of drug replacement therapy

DRT is a very diverse issue. Our counselors are happy to speak with you regardless of your position!

For It:

  • Some people believe that in order for THEM to achieve long-term sobriety, DRT is absolutely unavoidable. Many opiate addicts suffering through the pain of withdrawal symptoms believe the effects to be way too severe that they need help or they will not get through it. Long-term opioid use causes physical, emotional and psychological damage, resulting in the belief that living a normal life is out of the question. Offering a user a path out of this life and towards a brighter future might be their last hope.

Against it:

  • It is a fact that this form of therapy involves switching out one substance for another – in fact, that is even in the title! Both substances are highly addictive. Eventually the user will still need to stop using the methadone or suboxone, and that means they will need to detox, and begin the rehabilitation process all over again for their dependance upon this new substance. Those who speak out against DRT as addiction treatment believe it is flawed theory that is hurting the addict more than helping them.

Weigh the options.

A small percentage of addicts will truly benefit from this type of therapy therapy. Some long-term, heavy opiate users have severely damaged their bodies and would otherwise suffer intolerable withdrawal symptoms. It is important to bear in mind that this is a relatively small number of patients. The average addict will be more successful with their long-term recovery by avoiding all substances, including any drug replacement options.

There are always other factors concerning one’s struggle with sobriety. Some points to consider:

  • Chemical dependency is rarely the only or most serious problem. For some people the criminal issues they face, or the impulse to escape something in their environment by doing whatever they can to get the substance is the more relevant issue (versus the actual dependency on the substance itself). In these situations the priority is to break the individuals old habits, to develop a new environment and to learn new skills and to help the user become more self-aware so as to avoid old triggers and/or patterns of behavior.
  • Positive Reward. While in recovery, patients can become easily discouraged and depressed – they may even begin to feel that DRT is necessary because of their negative emotional state. After excessive opiate use, the human brain will decrease production of the chemical dopamine, which is found in the brain and which helps to regulate moods and feelings of joy. If patients have something positive after completing therapy that they can look forward to, this may help to alleviate some of the feelings of sadness or negativity that inevitably come with opiate withdrawal.
  • When other treatment methods have not been successful… DRT is an additional option available for you. Do not give up. Drug replacement therapy should not be your first choice, but if you decide it may be right for your situation – or if you would like to discuss it and receive more information – call us today!

So, what should you do for your recovery?

It’s frustrating when some doctors or clinics think just writing another prescription is the answer to your’s or your loved one’s drug addiction. At the same time,  it’s never easy admitting you struggle with drug dependency, especially if you have attended a rehabilitation program previously.