How are patients to overcome the stigma of medication-assisted treatment (MAT)? First, why is there a stigma at all? Let’s look at some of the reasons and discuss what to do about them:
- Opiate use disorder, and indeed any neuropsychiatric disorder, in itself carries a stigma. Unfortunately, some people judge patients with this problem rather than giving patients credit for getting help. Entering a MAT program is an individual health decision belonging only to the patient.
- Some 12 step programs, such as Narcotic Anonymous, see MAT as a form of drug abuse. Nothing could be further from the truth. Although buprenorphine (the active ingredient in Suboxone) is a partial opiate agonist it is not used for obtaining feelings of euphoria. It is designed to eliminate withdrawal signs and symptoms, giving patients a better chance to recover. In fact, while it has some opioid activity, it is also an anti-opioid (opioid antagonist) preventing overdoses and getting “high”. Patients entering 12 step programs should work with advisors who understand how buprenorphine works.
- There is some concern that patients will divert this medication. Since buprenorphine has almost no significant potential for abuse, diversion cannot contribute to the present opiate epidemic. When this medication is diverted it is usually for individuals who want to stop opiate use disorder but have no access to MAT for one of various reasons. Few physicians are trained in MAT, and those who are, are limited in the number of patients they are allowed to treat (x-waiver limit), so finding a program is not always easy. For some, financial concerns can be limiting. Some states have limitations on how long patients can be on medication legally, and since the disease can return, patients sometimes seek illegal means of getting the help they need. Some states require patients to try less effective methods of treatment before buprenorphine, and patients wanting early recovery do not want to bother with less effective treatments. When patients do divert buprenorphine it is usually to family members and friends who want to recover from opiate use disorder or are in an acute withdrawal state.
- There is a misconception that MAT could lead to death from opiates, but buprenorphine has been shown to decrease the incidence of overdose and death when trying to take other opioids while on buprenorphine. And an overdose of buprenorphine alone rarely leads to death, unless combined with other substances.
- Some people believe that buprenorphine patients just want to get opiates with insurance companies paying for it. Actually, experience with MAT shows that the vast majority of patients want to be free of opiates, and do not use this medication for “fun”.
The majority of physicians favor the use of MAT because of its effectiveness. Getting support from other MAT patients and noting progress along the way are great ways to avoid feeling the stigma. No one should have to deal with a stigma for getting medical care and getting sober. Each patient who overcomes opiate use disorder with MAT is more evidence that this stigma should be put to rest.
Where can I find MAT treatment?
QuickMD is the largest TeleMAT provider in the United States, treating tens of thousands of patients with opioid-use disorder every month—without the stigma or judgment many patients are used to.