SOME PEOPLE FIND RECOVERY THROUGH MEDICATION-ASSISTED TREATMENTS, LIKE SUBOXONE, VIVITROL OR METHADONE.
Alex Sheard remembers taking cigarettes out of an ashtray to smoke at 10 years old. He said he was never scared to try anything when he was growing up — a trait that didn’t go away.
“When my friends had coke, I tried it,” Sheard said. “When they had pills, I tried them.”
Sheard has been in recovery for four years, and he started taking Vivitrol — a medication that treats opioid dependence — in 2013. Two years ago, Sheard stopped taking Vivitrol because a medical professional suggested that he avoid having medication in his system at the time of a surgery.
But he said Vivitrol is what allowed him to enter recovery.
Prescriptions like Vivitrol fall under the umbrella of medication-assisted treatment, which is the use of medication and behavioral health therapies to treat substance use disorder. According to the American Society of Addiction Medicine, medication-assisted treatment is effective for people with opioid use disorder and is financially pragmatic for treating the disease.
A study conducted by the New England Journal of Medicine between 1995 and 2009 found that medication-assisted treatment caused a 50 percent decrease in the number of fatal overdoses in Baltimore.
Keli McLoyd works at the Treatment Research Institute — an independent research center that’s focused on treatment for substance use disorder. She said medication-assisted treatment is effective, especially when the patient is also using some form of psychosocial treatment.
“With that said, there is no requirement for psychosocial treatment in terms of what that looks like,” McLoyd said. “That could look like individual therapy, that could look like group therapy, that can look like a 12-step program.”
Sheard tried rehabilitation centers and 12-step fellowships, but didn’t find either effective on their own. He said Vivitrol was the only thing that “smashed” his craving for using.
“I was getting a divorce from getting high,” Sheard said. “It’s a miracle drug.”
Vivitrol uses naltrexone to block opioid receptors and the feeling of getting high. It can be consumed orally every day or injected in the form of a shot every month.
According to the American Society of Addiction Medicine, naltrexone’s “effectiveness is clear,” but its injection is the most expensive opioid use disorder medication. It is approximately $700 per monthly dose, according to AMSAM.
“What is access if you can’t afford it?” McLoyd said.
Sheard said that taking Vivitrol was unpleasant at times, but he is still an advocate of medication-assisted treatment.
Being on Vivitrol while attending therapy sessions helped Sheard learn how to manage his substance use disorder, he said. Now, he said his family, friends and therapist provide him an emotional outlet to support him in his recovery.
“I’m more aware,” Sheard said. “I see things differently. I see the world differently.”
David Frazier’s morning routine isn’t much different from anyone else’s. He wakes up, eats breakfast and shaves. But before he leaves the house, he takes his daily dose of Suboxone — a brand-name medication for people who are addicted to opioids that uses buprenorphine.
“It just feels so damn good to wake up in the morning, grab one of those strips and put it on my tongue and know that I’m going to have a good, productive day,” Frazier said.
Frazier has been in recovery for two years, which he credits partly to Suboxone, which blocks the effects of opioids similar to Vivitrol.
Frazier used Suboxone for the first time when he purchased it on the street to help with his opiate withdrawal. He kept using for a about a year and a half until he received a prescription for the medication in January.
“If it wasn’t for that Suboxone, I’m sure I would’ve been dead by now,” Frazier said.
In 2007, the National Institute on Drug Abuse conducted the first extensive, randomized clinical trial to study Suboxone’s effectiveness. In 2011, approximately 49 percent of the study’s participants reduced their substance use after taking Suboxone for 12 weeks.
When it comes to treating people in recovery, Dr. David O’Gurek said he believes “nothing fits in a vacuum.”
O’Gurek works in the Department of Family & Community Medicine at Temple University’s Lewis Katz School of Medicine. He has been treating patients with Suboxone since 2011 and said they are required to participate in external drug and alcohol counseling while taking the drug.
The department purposely prescribes patients with enough Suboxone to only last until their next doctor’s appointment, O’Gurek said. This is to avoid the distribution of the prescribed drug to another person for illicit use.
Frazier said Suboxone helps keep him out of situations that would put his recovery in jeopardy.
“I was just so glad that I didn’t have to chase anymore and do stupid things, you know,” Frazier said. “I was just so happy.”
According to the American Society of Addiction Medicine, methadone is the most thoroughly researched medication-assisted treatment. It is proven to curb cravings for opiates and suppress withdrawal symptoms.
Research has shown that methadone maintenance is more effective when it includes some form of counseling and medical, psychological and social services, according to the National Institute on Drug Abuse.
Barbara Mace has worked as the program coordinator at Jefferson Methadone Clinic on 21st Street near Washington Avenue for 18 years. The clinic requires psychiatric counseling and often recommends medication-assisted treatment, like methadone.
Mace said there are 420 patients who go to the clinic for treatment. In order for patients to be admitted, they need insurance, a Pennsylvania identification card and to “show a year history of opioid use disorder,” Mace said. She added that she hopes more people in need of assistance come to the clinic.
Mace said prescribing medication to treat addiction is no different than treating any other illness.
“Patients here are prescribed methadone, just as patients with diabetes receive insulin,” Mace said.