Medication-Assisted Treatment Or Detox?

By Kelly Burch 11/22/17

A new study examined the long-term effectiveness and costs of the two addiction treatment methods.

illustration of a man confused between two choices

Fighting opioid addiction with medication-assisted treatment (MAT)—particularly long-acting opioid medication like methadone and buprenorphine—not only increases a person's chances of getting sober, but is also more cost-effective than detoxing alone.

According to a study published in the journal Annals of Internal Medicine and reported on by The Los Angeles Times, using medications long-term rather than forcing people through detox would save $78,257 per person for taxpayers. 

If all people seeking treatment for opioid addiction in California over the course of a year were offered medication-assisted treatment rather than detox, the cost savings over the patients’ lifetimes would be $3.869 billion, according to the research. 

“We believe our findings really do represent the reality in California,” said Bohdan Nosyk, the study’s senior author. “The findings were really robust and, as new people come in, the savings will accumulate. So the numbers are conservative.”

Despite the potential to save billions of dollars a year, access to opioid addiction medication in California is strictly controlled. People who are on public insurance must show that they have completed detox twice and then relapsed, in order to have a prescription for methadone or buprenorphine covered. 

Last year the Surgeon General’s Report on Alcohol, Drugs and Health called for more use of medication-assisted treatment. However, then-Surgeon General Vivek Murthy said at the time that many people misunderstood the role of medications—especially those that contain opioids—in treating opioid addiction. 

“Many people are suspicious of methadone and buprenorphine, and they think that such medication-assisted treatment drugs do not have a place in treatment,” Dr. Murthy told The Fix. “They believe in abstinence and abstinence only, but science tells us very clearly that there are multiple paths to recovery. For some people, abstinence might be the right path, but that’s not necessarily the most effective path for everyone.”

The former surgeon general said that people also need to recognize that these treatments are administered in conjunction with counseling, rehab and even 12-step work. Taken as a whole, they are highly effective compared to trying to detox “cold turkey,” the recent study confirmed. 

“This is why it’s so important to raise awareness about the effectiveness of these existing strategies like MAT that do work,” said Dr. Murthy. 

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.