How to help someone struggling with opioids without rehab

Not everyone struggling with opioid use disorder (OUD) will be open to taking the path of traditional rehab for several reasons.

• Privacy: Conventional rehab operates on a community-based model with support systems both during and after treatment. While this may be suitable for some, others may prefer something more private than an inpatient treatment center. 
• Accessibility: Conventional rehab requires a sustained period away from work/school and other family obligations, which is difficult for the more than two out of every three Americans with OUD who have jobs and childcare needs. (1-2)
• Cost: According to statistics from American Addiction Centers, (3) the full cost of a 30-day program can range from $15,000 to $27,000, which is prohibitively expensive for most. Also, if there’s not a rehab center within close proximity to one’s home, travel costs need to also be considered.  
• Fear of relapse post-rehab: Conventional rehab has a start and end date, and while certain facilities offer ongoing support groups, it can be daunting to financially invest in a short-term treatment plan that has a 90% relapse rate within three months when not followed by medication. (4)

However, just because someone’s not choosing traditional rehab with a 12-step program doesn’t mean their only other treatment option is attempting to quit cold turkey — which, in addition to being incredibly difficult (arguably impossible), also carries the risks of detoxification without proper supervision. Rather, one should consider medications for addiction treatment (MAT) as an effective, evidence-based outpatient alternative. 

How to talk to a loved one about MAT

In order to introduce the topic of MAT to a friend or family member, you first have to understand what exactly it is, how it works, and what its benefits are:

About MAT

Medications for addiction treatment means that the person dependent on opioids will be prescribed an FDA-approved medication so they can successfully stop using heroin or misusing prescription opioids. 

How MAT works

There are several medications that are commonly prescribed as part of an MAT treatment protocol.

• Suboxone (combination of buprenorphine + naloxone): binds to the same receptors in the brain as traditional opioids but does not produce the same “high.” 
• Naltrexone: blocks opioid receptors, preventing patients from experiencing the effects of opioids while reducing cravings.
  

Benefits of MAT

Medication helps patients:

• Avoid withdrawal symptoms without going to detox (5)
• Relieve cravings (6)
• Lower the chances of relapse (7)
• Reduce the chances of overdose death by 70-80% (8)

Answers to frequently asked questions about MAT

When talking to a loved one about this alternative, effective treatment model, s/he may have questions…which is good! Here’s how you can answer them:

Does taking medication really count as treatment?

There's a widespread perception that you're not truly "sober" or "in recovery" if you're on medication — and that it’s just swapping one drug addiction for another; however, it’s worth noting how both the Substance Abuse and Mental Health Services Administration (SAMHSA) (9) and the National Institute on Drug Abuse (NIDA) (10) define “recovery” as: “A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.” While originally, this meant being “drug free,” it is now widely accepted that effective treatment can include the long-term use of medications such as Suboxone, as long as medication is taken as prescribed in doses that are not intoxicating and not interfering with daily activities and well-being.

Do I have to go to counseling or Narcotics Anonymous (NA) if I’m on MAT?

Medication for opioid dependence helps to relieve withdrawals, stop incessant cravings, and make it easier to feel normal in terms of focus and energy levels. That said, it’s important for everyone, not just those in treatment for opioid dependence, to have a support system throughout their lives. Many find tremendous benefit in having a place where they can talk about their experience with opioids and treatment. That’s where counseling and groups such as NA come in — but it’s not a prerequisite for MAT. 

How long do I need to be on MAT?

Most people require MAT for at least a few years, if not indefinitely. (11) Although some successfully taper off Suboxone with the close support of their healthcare provider without relapsing, it’s important to understand that if MAT is discontinued too soon, the risk of death often returns to close to what it was pre-treatment. 

Is MAT covered by health insurance?

For MAT through Ophelia, treatment is covered by a growing set of insurance plans, including AmeriHealth Caritas, Keystone First Health Plan, Fidelis, Empire BCBS, Highmark BCBS, Humana, Anthem CT, Geisinger Health Plan, and United Mine Workers Association.

If you don't have insurance or we aren't in-network with your plan, we have a transparent out-of-pocket pricing plan: $195 per month. This covers all of your visits each month.

Dual treatment for mental illness + OUD

Despite the downsides of traditional rehab programs and benefits of MAT outlined above, it’s important to highlight that certain treatment facilities may be preferred over MAT if mental illness is a consideration.

According to a 2019 national survey on drug use and health (NSDUH) conducted by SAMHSA, (12) 13.8% of adults aged 18 or older with serious mental illnesses also had substance use disorder related to opioids (versus 2.5% for adults with no mental illness). 

While Ophelia does address certain co-occurring disorders (mild-moderate major depressive disorder, generalized anxiety disorder, social anxiety disorder, PTSD, and insomnia), a dedicated drug rehab treatment program with a dual-diagnosis approach addresses a wider variety of psychiatric mental health conditions in a structured environment. This may include bipolar disorder, psychotic disorders (schizophrenia, schizoaffective disorder), obsessive compulsive disorder, treatment resistant depression, ADHD, eating disorders, panic disorder, and specific phobias.