Behind the Scenes at Phoenix Rising w/Misty Keen Evidence vs Experience

Well I've been busy doing all sorts of research between conferences, speaking with specialists, and interviewing individuals to gain more understanding evidence about MAT. I learned a lot of interesting facts I’d like to share how different professionals define MAT. Such as what science must inform us on which is when the specialists come in to play with our discussion on Medication assisted treatment. I also will talk about why this stigma affects most individuals with such negative feedback and outcomes.

 When I asked someone working in the field of treatment, they described Medicated-Assisted Treatment as the ability to use FDA- approved medications, in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to the treatment of substance use disorders. I also asked someone certified in harm reduction and they explained medication-assisted treatment as the use of medications and counseling to attempt to treat substance use disorders, but mainly to prevent opioid overdose. I also spoke with a prescribing physician about the responses I got from harm reduction and the treatment approach. I mentioned how a lot of people view it as replacing one drug for another, and he said that we are all right except “the drug that they’re replacing is a dangerous one that will kill, and it’s being replaced with a drug that allows you to go back to work, have money in your pocket, and allow others to live normally again. So, the definition no matter the source is basically another form of treatment, but the argument still stands…does it work?

Let’s get down to the science of it shall we? Understanding what heroin does in the brain and in the body is crucial to understanding why medication-assisted treatment works. Opiates work by crossing the blood-brain barrier and attaching to receptors on brain cells, which triggers a cascade of neurotransmitters and brain activity which produces the high that people feel. That brain activity can contribute to physiological dependence and, with genetic and psychological factors modify the way a drug is perceived. Medications associated with MAT sit on those same receptors and blocks them making it impossible to trigger neurotransmitters to produce the high in the reward center of the brain, avoiding physiological dependence. Sounds good, but what is really going on here?

The specialist really broke it down to me; she’s an addiction psychiatrist with 8 years of evidence supporting her work. She made it simple to understand these receptors in the brain creates activity that produces a physical dependence of the drug. Genetic disposition (genes) makes a person more likely to become addicted psychologically as well as physically which would be when she recommends MAT to clients. She explained it’s a complex neurological (brain) disease that affects the brain’s reward system making it harder for these certain people to remain drug free. Statistics show Suboxone is 50% effective and abstinence is 15% effective. By effective she means the people are living; medication assisted treatment is not a cure all and is not for everyone, but it is effectively proven to reduce overdoses. The hope is that it gives individuals the opportunity to receive evidence-based treatment and therapy, while putting blocks on receptors to stop cravings. Therefore, the individual can start implementing new behaviors enabling brain activity that develops new neuro pathways to the reward system, providing beneficial treatment. She also said there is a safe taper protocol after 1-2 years to make treatment successful! She then drew a picture of the side view of the brain to try to explain what’s going on between the conscious (top half) and subconscious (bottom half)!

“A nation that demonizes the alcoholic, that breeds the very feelings of stress and isolation that are often at the root of the dependency, that relies on coercion rather than persuasion, will ultimately be less just and less successful” -Abe Lincoln

To conclude this blog and my MAT investigations, I saved the best for last! These interviews with individuals practicing MAT truly shook me to my core! They have started a new 12 step meeting called MARA because of the prejudice at other support meetings. They found it impossible to be open and honest, they were willing but turned away. Adding more shame to the shame they already have; some have let the judgments take them back out, some made it back some did not! MARA is small and not many people know of it, so I’d like to put the word out there! Medication Addicted Recovery Anonymous! I personally have grown and made a realization within my own recovery and the principles I’ve been lacking to practice! So bottom line is MAT is saving people from overdosing, and just like with any treatment sometimes it works sometimes it doesn’t, we don’t know until we try. I want to help save lives; all lives no matter the complexity. There may be something to this medication assisted treatment thing after all. I really enjoyed learning and growing through all of this and want to thank you all for being a part of my journey. I’d love to know what you think, I am completely open to any and all feedback!