Treatment Options Study Essay

As previously discussed, the program the author would choose to evaluate is MAT treatment programs. This population consists of individuals that have been diagnosed with opiate use disorder, and receive opiate-substitution medications, such as Methadone or Suboxone. These program evaluations would be consumer-centered, performed in the clinics they receive services. Interested stakeholders would include the treatment center where the participants receive services, as well as other MAT service providers. Additionally, the funding sources for these individuals and program centers, such as county, state, and federal agencies, along with medical insurers, would also gain value from the program evaluation research.

Lauren Smith is a five year old Caucasian girl who is demonstrating anxiety when separated from her mother. The family was referred to this service by their pediatrician. Over the past few months, Mr. and Mrs. Smith report Lauren has become increasingly troubled when being separated from her mother. She cries while clinging to her each morning before school and her father describes having to “pry her off” and carry her to the car. Lauren’s parents are also concerned with regressive behavior; she is speaking more often in third person when referring to herself, and she has also begun wetting the bed nearly every night. Mr. and Mrs. Smith had a conference with Lauren’s teacher two weeks ago at which time she told them Lauren was having difficulty concentrating and completing her work. The teacher also voiced concerns about her lack of interest in participating in group activities; she appears to prefer to play by herself. The parents report that Lauren is otherwise healthy and has been meeting age appropriate developmental milestones.

Will you need or want to contact the parent or obtain parental permission for counseling services prior to meeting with Geoffrey? Why or why not?

There are a variety of treatment modalities, both conservative and emerging, that clinicians, therapists, and doctors use to treat heroin and opioid dependence. Cognitive behavioral therapy (CBT), motivational interviewing (MI), 12 step programs, and acceptance and commitment therapy (ACT) are just a few that have been used in the past, and even today, in the treatment of substance dependence. Medication-assisted treatment (MAT) is yet another form of therapy; particularly for opioid and heroin dependence, that has been around for decades. However, it has recently begun to spark interest and controversy in light of the growing epidemic.

Medication assistant treatment also known as (MAT) is when a person has presented with an opioid addiction and have challenges stopping and/or abstaining from opioid use and they are prescribed either Methadone, Suboxone, or Vivitrol. Those who are in support for MAT is that this a better alternative to having individuals addicted to illicit substances. The other side to MAT is that this is way to keep individuals addicted to drugs, legally. I do not support MAT treatment as a form of long term treatment and not as the solution for opioid addiction. Serving as an Addiction Counselor and working with individuals who are addicted to opioids, I encounter many individuals who are or at one point utilized

Methadone Maintenance Therapy (MMT) is used with opioid dependency and is an opioid replacement therapy. MMT typically replaces heroin with Methadone which is a cleaner substance than heroin, and is used to avoid withdrawal and allow the user to function normally within society. MMT has been around for the last 50 years, and research studies have been conducted to address the benefits and the complications associated with this replacement therapy. This paper will examine some of the advantages and disadvantages associated with MMT and reflect on personal ideals in accordance with MMT.

Dr. Perry Kendall’s stated in a report that the mortality rate for people in opioid substitution treatment is about half of what it is for those using street heroin. (“globeandmail”) Another doctor, who has been administering the program as part of his family practice for several years states the rate of success is poor, the nature of the work often frustrating and the paperwork required under new rules is daunting. But the reward is the amazing transformation of those who are helped by methadone, says Dr. Jeff White. (“thetelegram”) Equally, a confident experience is expressed from a recovering addict himself, Jared stated to a Newfoundland based newspaper, The Compass that the methadone program had a super positive impact on his life. Going on to say in a separate interview with The Advertiser, that the first year everything went as well as it could have with him not doing any drugs. (“Advertiser”) This is just a few examples on how the methadone program has continued to play a positive impact on lives when given the

Before the study by Roose et al. (2012), however, David Frank approached the stigma concept from an entirely different perspective (2011). Frank believed in the negative perceptions of MMT mentioned by Roose et al. (2012), but pointed to long-standing twelve-step programs as the driving force behind that negativity. Frank’s study investigated this hypothesis by interviewing four individuals from each of four different types of opiate abuse categories. His categories included current heroin users not seeking any type of treatment, heroin addicts using twelve-step programs and no illicit opiates, former heroin addicts on MMT with no illicit opiate use, and former heroin addicts on MMT who also used illicit opiates. Believing that twelve-step programs promote abstinence to a point that is unproductive for addicts, Frank’s study pitted MMT, as the “medical model,” against programs like Narcotics Anonymous as the “moral-spiritual model” (2011). The medical model approaches treatment from

The practice that assist a therapist in determining a client diagnosis and the proper treatment plan that would resolve the issue surrounding the clinet’s diagnosis is Case Conceptualization and Treatment Planning. The clinet’s treatment plan must be appropriate and relational and this will alow any type of medication and adaptions to be adjusted if needed so that modifications and adaptations can be adjusted as needed (Altman, Briggs, Frankel, Gensler, and Pantone, 2002). The ultimate goal of case conceptualization and treatment planning is to discover complete findings in relation to the client. One approach is Existential Therapy. The human

ESSENCE OF THE STORY: In the past few years, opioid addiction has become an epidemic in the United States leading to around 64,000 people dying from drug overdose in 2016 alone. As a result the health and human services secretary, Mr. Azar, and the F.D.A. chief, Dr. Scott Gottlieb, has made battling opioid addiction a top priority. The main way the F.D.A. is attempting to battle the epidemic is by allowing pharmaceutical companies to sell new types of medications that aren’t meant to stop addiction but to help suppress the cravings of addiction. The new medication that the F.D.A is approving is supposed to be a part of the program MAT, or medication-assisted-treatment. Mr. Azar as well as Dr. Scott have been pushing for more MAT in hope to help people with addiction live productive lives. Though like most big changes in society, the F.D.A’s decision has drawn criticism. Addiction experts are saying that new medication isn’t the solution but more access to the medication is.

It was stated in the presentation that the sample sized used for the study was 175, but of the 175 study participants 44 discontinued treatment 16 in the methadone group and 28 in the buprenorphine group leaving 131 participants, the proper sample size could have been identified on the slides to give the reader a more accurate idea of the sample size used.

The main threats identified in the study fall under the historical category. The study began with 175 participants beginning treatment, but only 131 women finished the study; 28 women on buprenorphine and 16 women on methadone dropped out of the study, showing distinctly different rates of attrition. As a result, the outcomes of the study could have shown bias in favor of the buprenorphine group. However, statistically, there were no significant between-group differences in women who completed the study and those who did not, suggesting that the differences in attrition rates are unlikely to explain the outcomes. The authors of the study explicitly addressed this concern and stated that the results should, “Be considered in light of the markedly different rates of attrition” (Jones, et al, 2010, p. 2330). They also discussed possible reasons for the differences in attrition rates and said that the rates should not matter as the final analysis conducted excluded women who were on over 100 mg of methadone, removing 19% of the sample. In terms of subject maturation, testing, and instrumentation, there are no

Harm reduction is a concept that refers to policies, programs, and practices that aim to reduce the harms associated with the use of psychoactive drugs in people unable or unwilling to stop (Syme, Browne, Varcoe, & Josewski, 2011). Methadone has been increasingly utilized as a means of addressing and reducing the health, social, and fiscal harms associated with opiate addiction (Kerr, Marsh, Li, Montaner, & Wood, 2005). During my clinical rotation at Rosthern Hospital, I learned that this small town rural hospital has a successful methadone program to treat opioid addiction. When a person thinks of small town Saskatchewan, their first though is not usually intravenous (IV) drug use, but after working at Rosthern Hospital for a few shifts, I began to realize the town and the surrounding communities may have an addictions problem. At the hospital, the doctors, nurses, pharmacists, and support staff have all decided to collaborated and developed a harm-reduction methadone program for their patients. Not only is this program successful because it addresses the needs of the community, but it is also controversial. Using Carper’s (1978) “Five Ways of Knowing” I examined the methadone program and its patients, the positive and negatives, as well as a patient’s own personal experience being in the methadone program.

To begin, opioid abuse and addiction have increased in frequency in the United States over the past 20 years.4 In 2009, an estimated 5.3 million persons used opioid medications nonmedically within the past month, 200000 used heroin, and approximately 9.6% of African Americans used an illicit drug.4 Racial and ethnic minorities experience disparities in availability and access to mental health care, including substance use disorders.4,7 Primary care practitioners are often called upon to differentiate between appropriate, medically indicated opioid use in pain management vs inappropriate abuse or addiction.4 Racial and ethnic minority populations tend to favor primary care treatment settings over specialty mental health settings.5,6 Recent therapeutic advances allow patients requiring specialized treatment for opioid abuse and addiction to be managed in primary care settings.4 The Drug Addiction Treatment Act of 2000 enables qualified physicians with readily available short-term training to treat opioid-dependent patients with buprenorphine in an office-based setting, potentially making primary care physicians active partners in the diagnosis and treatment of opioid use disorders.4,11

Dr. Frankenburg details the new replacement therapy for opiate addiction called buprenorphine, a semisynthetic opiate that comes from the thebaine, found in the poppy plant. While buprenorphine has effectively gotten those on heroin and other opiates off, it does perpetuate itself in that many do not come off it at all, but rather stay on it indefinitely as their addiction remains. This article lays out the groundwork in my research for treatment for substance abuse and how applies to improving the relationships of addicts with