The addiction to opioids such as heroin and prescription pain relievers (e.g. oxycodone, morphine, hydrocodone, hydromorphone, etc) may affect 2.1 million in the United States)(1). Medication assisted therapy may include methadone, buprenorphine (e.g. Suboxone, Subutex, etc), or naltrexone (Revia or Vivitrol). Methadone and buprenorphine can be prescribed for maintenance and/or detoxification while naltrexone is used after detoxification. Individuals engaged in MAT therapy have reduced risk for relapse and complications such as hepatitis C, HIV and death.
Considering the consequences of stopping maintenance therapy, the decision for detoxification should be individualized. Sometimes a rapid detoxification can be tolerated while other times gradual is preferred. Sometimes after multiple efforts for detoxification have failed; a longer duration of maintenance therapy is beneficial.
When people who are receiving MAT for opioid dependence abruptly discontinues treatment, the result may be uncomfortable and/or life threatening symptoms of withdrawal. A study compared maintenance versus rapid detoxification therapy as they correlate to long term outcomes and participation with future MAT programs.
In a monitored, randomized, open label trial that took place in Rhode Island over 659 days, 9 doctors studied 238 people receiving methadone maintenance treatment. Sixty patients did not meet inclusion criteria; 114 were selected for the methadone maintenance, and 109 were selected for rapid detoxification (e.g. the withdrawal group).
After the study ended, participants assigned to methadone maintenance treatment were more than twice as likely to return to a methadone program to engage in treatment. There were no serious adverse events noted between the groups.
Study numbers suggest that withdrawal from methadone after receiving maintenance treatment reduced the likelihood of a person re-engaging in methadone maintenance treatment a second time. Continuation of methadone maintenance treatment results in a longer time engaged in treatment, thereby reducing the risk of relapse and death. Abstinence from all opioids is desired by most but a risk-benefit analysis should be conducted before withdrawing MAT therapy.
If you or a loved one is struggling with opioid/opiate/heroin addiction, Associates In Medical Toxicology can provide MAT therapy alongside counseling from a licensed drug & alcohol provider. AMT can provide maintenance and/or detoxification therapy.

Share This: