How do we Measure Success?
The success rates for addiction medications can be difficult to understand, especially when trying to find the best treatment option for a loved one. The reason for this confusion stems from the way in which health professionals measure success with different strategies they employ.
Maintenance Therapy vs. Reduction Strategy
- Maintenance Therapy Strategy
Maintenance therapy refers to the action of substituting a drug of abuse with an alternate therapy that binds to the same receptors, reducing the feelings of euphoria and cravings. These are typically achieved through drugs such as methadone and buprenorphine. Maintenance therapies may precipitate their own respective side effects such increased anxiety, psychological dependence, and changes in mood.
- Reduction Strategy
Reduction strategies employ the use of the same maintenance drug therapies with the intention of tapering and discontinuing the maintenance therapy.
- Reduction therapies
Reduction therapies are typically a goal for all patients with substance use disorders since maintenance therapies may precipitate their own respective side effects such increased anxiety, psychological dependence, and changes in mood.
Maintenance Therapy vs. Reduction Strategy Success
- Maintenance Therapy Success
Both methadone and buprenorphine are quite successful when it comes to maintaining an individual on their respective treatments at rates of 70-90%1,2,3 and 60-90%,4,5 respectively at 1 year of therapy.
- Reduction Strategy Success
However, when speaking about withdrawing the medication and staying clean, the success rate is actually quite bleak, where those who taper off of methadone (less than 50% are able to taper) typically report a 26% success rate after 6 months of discontinuance of methadone,6 and only an 8.3% success rate after discontinuance of buprenorphine after 3 months of therapy.
These medication alternatives could potentially leave people on these types of therapies for years, or even for the rest of their lives. There must be a better alternative!
A Possible Solution to Addiction
- Naltrexone blocks the opioid receptor, instead of stimulating it.
- Studies performed on Naltrexone implants have touted maintenance rates of up to 80% after 6 months of therapy, and a 65% retention after 1 year of treatment.7
- For 6 months after discharge 55.4% still returned for their follow up visits and remained abstinent to opioids.7
The results of currently published studies for implantable naltrexone tend to show that the success rate of implantable naltrexone is much greater than that of other medication alternatives when withdrawing the treatment, allowing many to live medication and drug-free.
A Two-Pronged Approach
- Longer Acting Naltrexone
Naltrexone Solutions promotes the use of a non-addictive, dissolvable implant formulated to reduce cravings and increase success of addiction recovery programs. The implant, inserted painlessly just below the skin, slowly releases naltrexone into the bloodstream in a sustained dose for several months. This may reduce cravings, and prevent the reward effects with subsequent opioid and alcohol use.
Psychosocial and Psychological Support
Treatment of addiction with medication are NOT cures, and must be supplemented with psychological and psychosocial therapies. Psychological therapies are typically used to address the root cause of the addiction, which in often cases stems from deep rooted mental, psychological or physical trauma.8 Studies have shown that as many of 96% of treatment seeking substance users report experiencing some kind of major traumatic event.8
Naltrexone does not cause the emotional numbness often experienced with other medication treatments available for addiction, thereby allowing therapies such as cognitive behavioral therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR) to have a fighting chance at success by allowing those receiving therapy to feel their emotions and deal with the trauma at hand.
- Davstad I, Stenbacka M, Leifman A, Beck O, Korkmaz S, Romelsjo A. Patterns of illicit drug use and retention in a methadone program: a longitudinal study. J Opioid Manag 2007; 3: 27–34.
- Comiskey CM, Cox G. Analysis of the impact of treatment setting on outcomes from methadone treatment. J Subst Abuse Treat 2010; 39: 195–201.
- Peles E, Schreiber S, Adelson M. Factors predicting retention in treatment: 10-year experience of a methadone maintenance treatment (MMT) clinic in Israel. Drug Alcohol Depend 2006; 82: 211–7.
- Curcio F, Franco T, Topa M, Baldassarre C. Buprenorphine/naloxone versus methadone in opioid dependence: a longitudinal survey. Eur Rev Med Pharmacol Sci 2011; 15: 871–4.
- Soeffing JM, Martin LD, Fingerhood MI, Jasinski DR, Rastegar DA. Buprenorphine maintenance treatment in a primary care setting: outcomes at 1 year. J Subst Abuse Treat 2009; 37: 426–30.
- Isiandiso, OOA: Success Rate of detoxification from Methadone Maintenance in an Ambulatory Care Unit. Journal of the National medical Association. 1997;63(3):175-176
- Carrebi, JE Maintenance treatment with depot opioid antagonists in subcutaneous implants: an alternative in the treatment of opioid dependence. Addcit Biol. 2003 Dec;8(4):429-38.
- Rosenthal, M. (2015, March). Trauma and Addiction: 7 Reasons Your Habit Makes Perfect Sense. Retrieved February 05, 2016.