Dr. Jana Burson Blog: Who Should NOT Be in Medication-Assisted Therapy with Either Methadone or Buprenorphine?

“I spend much time and effort explaining how medication-assisted treatment for opioid addiction works for many addicts. It occurred to me that I should explain who isn’t a good candidate for such treatment.

I enthusiastically support medication-assisted treatment (MAT) of opioid addiction, but no treatment works for everyone. MAT doesn’t work for every opioid addict.” Dr. Burson offer ten reasons a patient may not be suitable for MAT including:

  • The patient isn’t addicted to opioids.
  • The patient takes opioids for pain, but has never developed the disease of addiction.
  • The opioid addict presenting for treatment has been physically dependent for less than one year.
  • The opioid addict has the ability to go to a prolonged inpatient residential treatment program for his addiction.

All this is to say that the goal of entering an opioid treatment program isn’t necessarily to
get off the treatment medication.

So if a patient seeks to enter methadone treatment but also expresses a desire to be off buprenorphine or methadone within weeks to months, I tell them their expectations aren’t realistic. These medications don’t work like that. If the patient wants to get off all medications quickly, they need referral to an inpatient program. This way, patients can’t later say they were mislead, and they feel like they have liquid handcuffs, chained forever to methadone, with its many regulations for treatment.’

http://janaburson.wordpress.com/2014/01/05/who-should-not-be-in-medication-assisted-therapy-with-either-methadone-or-buprenorphine/

Source: Jana Burson – MD  – January 5, 2014