By Danielle Nick
As an Associate at the Treatment Research Institute (TRI) and a person in long term recovery, Keli McLoyd views addiction through two different, yet equally valuable lenses. However, McLoyd said she tries to separate her personal history with addiction from her decisions as a policy maker. Essentially, McLoyd’s job entails gathering research about addiction and deciding why and how the findings matter. On the back of her business card, it reads “Research Based Solutions For Substance Use Problems.” McLoyd reminded our class to pay attention to science and separate concrete facts from mere opinions. Regardless of our personal views, the facts demonstrate that medication-assisted treatment is working. “These medications work, they’re cost effective, and they’re saving lives,” McLoyd said. McLoyd went on to review resources that provide an array of statistics about addiction.
Substance Abuse and Mental Health Services Administration (SAMHSA) is a website chock full of resources. For instance, there is state by state data on addiction and even a tab devoted to helping people find appropriate treatment. Every person is different, so some people might need an inpatient intensive program, while others might require an outpatient program. Also, some people looking to get clean and sober might want to learn more about medication assisted treatment. SAMHSA has information from each state about which doctors are authorized to treat their patients with buprenorphine, a drug that treats opioid dependency. The American Society of Medicine was another great resource McLoyd show our class. This organization specializes in medication assisted treatment. There are different seminars and courses medical doctors can attend to help educate them on addiction.
After reviewing resources, McLoyd discussed three different FDA approved drugs used for medication assisted treatment. Buprenorphine, which she briefly discussed while reviewing the SAMHSA website, methadone, and naltrexone are all FDA approved. Buprenorphine is often referred to by its brand name, Suboxone. In order to receive this drug, doctors have to be waived and approved to treat their patients. McLoyd described a drawback of the drug. Since not every doctor is waived, it creates a tremendous workload for those who are approved to treat patients with the medicine. Then, McLoyd discussed methadone, which she referred to as “the oldest, tried and true medication.” McLoyd discussed how people get methadone at a clinic. She also said how methadone is relatively cheap compared to other drugs used for treatment. However, there are certainly drawbacks. McLoyd urged everyone in our class to go to a methadone clinic to see what the experience is like. It is an easy or pretty place to be. Also, there is this prominent idea of “not in my backyard” or N.I.M.B.Y. Some people do not like the kind of clientele methadone clinics attract, so this limits the location and the amount of facilities available. So, if someone needs to get to the clinic everyday, but the nearest facility is 20 miles away, this creates a major transportation and convenience issue. The last medication McLoyd discussed is naltrexone, which can be given in a daily pill or a monthly shot. Physicians do not have to be certified to administer naltrexone. However, McLoyd explained, “A lot of primary care physicians don’t want to deal with addiction.” In response to this, TRI has been trying to push for more addiction medicine courses. Hopefully, with more doctors educated about addiction, more will be be motivated to make a positive difference. McLoyd discussed how the monthly shot, vivitrol, appears to be the easy answer. People can avoid having to travel to a methadone clinic, and they don’t have to worry about taking a daily pill. So, why doesn’t everybody take vivitrol? McLoyd let us know vivitrol costs $1,000 per shot. Clearly, this high price would be a major deterrent for many people. After reviewing these three medications used to treat substance use, McLoyd reminded us that, generally, these medications do not work on their own. McLoyd stressed the importance of combining psychosocial treatment along with medication. For example, people getting vivitrol have a better chance in their recovery if they also attend 12 step meetings or counseling of some sort. These medications can absolutely save lives, but other coping mechanisms are vitally important.