New Jersey Pushes Back Against Medication-Assisted Treatment

By Zachary Siegel 08/05/15

If you take Suboxone or methadone, are you really clean? The debate rages on.

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This week, New Jersey’s Division of Addiction Services was awarded $950,000 by the federal government to expand the use of medication-assisted treatment (MAT). These type of treatments are being pushed by the Obama administration to combat opioid-related mortality sweeping across the country. 

New Jersey happens to have one of the highest overdose rates in America. 

"This grant will allow us to treat more people who are battling the war against heroin and opioids by using a proven method that brings specialized recovery services right to their neighborhood," said Department of Mental Health and Addiction Services Assistant Commissioner Lynn Kovich.

The push for MAT once again raises the tired question of whether or not you're clean and sober if you’re undergoing MAT. Danielle Orlando, who receives MAT through a Suboxone regiment, was interviewed by reporter Stephen Stirling.

On the problem of being clean she said, “I don't really go to (Alcoholics Anonymous) or (Narcotics Anonymous), because a lot of people there don't think I'm clean. They say it's just a crutch. But it's totally different. It's a medication for a disease. Nobody is going out and getting high off of Suboxone. I wish more people would understand that."

New Jersey’s drug court system perceives MAT differently. Drug courts look to methadone and Suboxone as going against their aims of getting drug users off drugs. According to the courts, people on opiate maintenance are not clean or sober because these drugs are activated on opioid receptors.

The ardent critics of MAT argue that like methadone, Suboxone has street value, is addicting in itself, and has an intense withdrawal syndrome. These are the common reasons cited in order to privilege an abstinence-based model that failed to work on Orlando.

The same report interviewed Lynda Bascelli, medical director at Project Hope. She said, "It shouldn't be easier to get heroin than Suboxone. This treatment isn't going to be for everyone. But for an addict, addiction is their acute life-threatening disorder. If you don't address that, they could die. It's no different than treating diabetes, from a medical standpoint."

What does Bascelli mean when she says this treatment, meaning MAT, isn't going to be for everyone? Users such as Orlando had gone through multiple treatments and tried several different approaches and Suboxone happened to be the approach that helped her regain her life. Not everyone going through the ringer of kicking an opiate habit will share that experience. Some may not undergo MAT where others will.

As more and more lives are impacted by the surge of heroin use in the U.S., we will begin to see new and novel approaches being implemented to help those who suffer.

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Zachary Siegel is a freelance journalist specializing in science, health and drug policy. His reporting has also appeared in Slate, The Daily Beast, Salon, Huffington Post, among others. He writes often about addiction, sometimes drawing from his own experience. You can find out more about Zachary on Linkedin or follow him on Twitter.