Gateway launches new medication-assisted treatment program in Center Township
By Jenny Wagner, Beaver County Times, Pa. | |
McClatchy-Tribune Information Services |
The medication-assisted treatment program, which began about a month ago at Gateway's
Although MAT programs have been somewhat controversial, Gateway medical director and addiction psychiatrist Dr.
"With addiction, historically ... treatment was mainly based more on counseling and spiritual work, which is still very important," Capretto said. "But as science has progressed we've learned more about the brain and genetics and we have new tools in our toolbox that when you add to your traditional treatment you can sometimes get better much better results."
Gateway has been using medications in treatment programs for years to help patients with things such as detox and cravings. But a "disturbing trend" in the number of opiate-dependent patients not completing treatment, as well as high relapse and overdose rates prompted the center to do more, according to
"We felt that we needed to respond to that trend because a lot of the patients that are coming into our detox and inpatient treatment programs, a lot of them are opiate dependent," Foster said.
Capretto said Gateway, like several other organizations across the country including the
"Treatment for addiction, like with any medical condition, should never be one-size-fits-all," Capretto said.
Gateway's MAT program is designed to help stabilize patients so they can remain in treatment and rebuild a healthy life. Since the program is still new, officials currently are selecting patients who can start while in inpatient treatment, and then follow through in outpatient treatment afterward
Suboxone, a medication that dissolves under the tongue, is used to suppress withdrawal symptoms and decrease cravings in patients who are opioid-dependent. While it is still an opioid, Capretto said the effect is gradual compared to a short, quick effect such as heroin, and most patients who have a tolerance report feeling normal while taking it.
The point, Capretto said, is to take away the ups and downs of substance use.</p>
"It's meant to help normalize you to get out of that cycle of addiction which is like a roller coaster literally," he said.
A second medication, naltrexone, is available as a monthly shot or a daily pill, and reduces cravings and blocks the effects of opioid drugs. It can only be given after patients have detoxed, and it helps keep them from relapsing if they use opioids again -- Capretto describes it as a "bulletproof vest" from opioids.
Patients have to see their physician once a week to get the Suboxone prescription and the Vivitrol shot once a month. The shot can be quite expensive and is not always covered by insurance, Capretto said, but Gateway also uses a less-expensive daily pill form in the MAT program.
The medications help increase the chances that patients will make it to medical appointments, get to weekly individual and group therapy sessions and overcome the hurdles in the early stages of recovery from the disease of addiction, Capretto explained.
"The longer you stay involved the better your chances because it is a chronic condition," he said.
Foster said the program also helps patients manage some of the less obvious challenges of life in recovery, such as transitioning between facilities, transportation to and from meetings or appointments, employment issues or building a sober support network.
"A lot of patients when they step down from inpatient to outpatient also have a lot of other issues they're dealing with," he said.
Many doctors have become certified to prescribe Suboxone since it was approved more than a decade ago, but not all of them combine the medication therapy with the supports that are part of an MAT program, Capretto and Foster pointed out.
"We feel it's a balanced way," Foster said. "We know there are sometimes concerns from the recovery community and people who say, 'You're an abstinence-based program,' but if someone is on medication but they're using it properly and not to alter their minds, then to me they're in recovery."
Capretto stressed that Gateway does not offer a prescription-only program and that addiction is a "bio-psycho-social-spiritual" disease and good treatment should evaluate each of those areas and address them in the best way.
"There is no such thing as recovery in a pill," he said.
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