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What Are the Benefits of Office-Based Opioid Treatment Programs?

by Cathy Garwood

When treating opioid addiction, there are several options for people to consider. There are inpatient and outpatient services available, but another alternative is called office-based opioid treatment, or OBOT, and it offers many advantages. This method provides medication-assisted treatment (or MAT) by using medicines like buprenorphine with or without naltrexone (Suboxone, Buprenex, Subutex, Butrans, Zubsolv) or naltrexone (Vivitrol), along with counseling and other recovery services. OBOT is suitable for patients who are looking for an alternative to methadone treatment which is also a MAT (medication-assisted treatment) for OUD (opioid use disorders).

What Does OBOT Involve?

Office-based opioid treatment requires a medical evaluation and physical exam performed by medical professionals. Upon the initial assessment, patients are prescribed medicines like  buprenorphine (Subutex, Buprenex, Butrans), buprenorphine/ naloxone  combination (Suboxone, Zubsolv), or naltrexone (Vivitrol® ) to help bypass opioid withdrawal symptoms and discourage further drug misuse. This plan does not require patients to visit the clinic every day as they are given prescriptions for their medications. Along with MAT, patients will also work with an individual counselor to create a personalized recovery plan, including therapy, group and family support, drug screenings, and other services. Using this whole-patient approach, people are more likely to be successful in long-term recovery.

What is Buprenorphine?

Buprenorphine is a prescription medication that acts as an opioid partial agonist. Its chemical makeup is similar to opioids, but to a lesser extent, helping relieve symptoms of withdrawal in patients who have been using high doses of prescription or illicit drugs. While doses of this medication can increase, they do “level off” at a certain point, helping prevent the risk of misuse, dependency, and negative side effects. Since this medication is a long-acting agent, it is safe and effective when taken as prescribed.

When patients are given buprenorphine, they will start to feel relief within 30 minutes to an hour of receiving their dose. Since everyone’s metabolism varies, the duration of the effects will last all day for some, but not for others due to factors like tolerance and dosage. When people attempt to misuse buprenorphine/naloxone combination using it via IV injection, they will experience instant withdrawal symptoms, making this side effect a deterrent for those who attempt to illicitly use the medication. . Treatment length depends on individual needs, sometimes lasting several months to several years depending on the suggested plan.

Benefits of OBOT Programs:

Increased Access to Treatment

OBOT gives people access to drug treatment without having to go to a traditional rehab. Doctor’s offices are able to supply patients with prescriptions for buprenorphine and monitor their progress with periodic visits. This opens up more opportunities for people to seek treatment for opioid addiction, which can be very difficult to do without MAT. Many people with substance use disorders are afraid or ashamed to seek help for their addiction due to stigma or denial, by placing OBOT for opioid addiction on the same level as other medically necessary treatments, people will be able to ask for help in more places than standard drug treatment centers. This is one step that can help battle the ongoing opioid epidemic in the United States.

Treating Comorbid Disorders

Many people with substance use disorders are also dealing with other mental illness like depression and anxiety. With OBOT, a doctor can help the patient with their addiction and other medical issues they may be facing by prescribing the proper medications to manage symptoms. Patients also have access to therapy with counselors who can help their recovery process by focusing attention on underlying issues that may have fueled their addiction. Treating addiction without treating co-occurring disorders rarely allows for successful recovery. Present mental illness usually causes patients to relapse, or is a result of their previous drug misuse. Healing addiction and other disorders from all angles using a whole-patient approach increases the rate of recovery significantly.

Decreased Stigma

Though attitudes about addiction are slowly changing, many still do not recognize it as a disease. Just as any other disease is treated by medical professionals, addiction management should also be considered a medical necessity. Unfortunately, rehab facilities and methadone clinics are viewed negatively, even though people enroll in those programs are successful in the treatment of their opioid use disorder.  The stigma surrounding people who have substance use disorders still exists and is the leading reason people often do not seek help. Even when people do reach out for help, they are still viewed negatively, and so are the treatment facilities.

The opioid epidemic in America is still booming, causing hundreds of thousands of overdose deaths each year. These deaths are preventable and opioid addiction is treatable. Many patients have found success with buprenorphine and OBOT, making it a top choice for people with substance use disorders who are looking for an alternative to traditional detox, rehabs, and methadone clinics. HCRC offers treatment with buprenorphine at four locations in Maine and Massachusetts through an office-based opioid treatment program, making recovery available to all people, regardless of what phase of opioid misuse or addiction they are experiencing.

 

 

Sources:

https://www.asam.org/docs/default-source/public-policy-statements/1obot-treatment-7-04.pdf?sfvrsn=0

https://jamanetwork.com/journals/jama/fullarticle/194273

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4682362/

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