ABSTINENCE-BASED TREATMENT ALLIANCE
Addiction is much more than a brain disease, and we should not limit our treatment to medication replacement therapy alone. It is time to reintroduce abstinence to the national discourse.
Sadly, the treatment landscape has moved toward monetizing the addict for another’s gain. Despite the well intentioned drug protocols for opiate replacement therapy, there is no medication that can make a person change their behavior. Learning a new behavior takes focus, practice, and persistence. Several studies now show that medications designed to treat opiate dependence (such as Buprenorphine) cause, and/or extend cognitive impairment, i.e., executive functioning, information processing speed, and verbal and non-verbal learning. These are the brain mechanisms we need activated for circuitry changes, particularly--Neuroplasticity, to take place. The faculties one needs to focus and change behaviors are impaired with opioid replacement therapy and this impairment will prevent new learning. Additionally, drug maintenance treatment will demonstrate impairment that also emphasizes levels of dis-inhibition, risk-taking, and poor problem solving skills. The very traits proven to be very prominent and problematic in addiction. Universal relapse after discontinuance of these medications speaks to being an option that just serves to kick the can down the road.
Studies have shown that younger individuals from 18 to 25 fail to stay abstinent when put on an opioid medication alone. Seventy-five percent of the remaining patients quit the drug protocol and resume using because they cannot tolerate their own emotional states and life’s challenges. These particular medications will not take away anxiety, worry and stress. A craving is more than a sum of its parts.
It is noted that for some opioid-dependent individuals, opiate substitution drugs, such as Methadone and Suboxone is required long-term, and in the most severe cases, for life. For some, this is a last resort to reduce harm or decrease adverse health, social and economic consequences of legal and illegal psychoactive drugs. However, we should be concerned and remain vigilant about the unwarranted, over prescribing of opiate replacement drugs that render behavioral modification and neuroplastic changes in the brain to be non-existent.
(http://www.abtanow.org/site/)