Viewpoint: Therapeutic counseling is essential

By Dan Johnson


In the long battle fighting opioid addiction, medication assisted treatment (MAT) has risen as the gold standard of treatment options. Unfortunately, many people consider the two most well-studied medications, buprenorphine, the primary drug in Suboxone, and methadone, as the sole treatment focus.

There is no question but that these medications have saved countless lives among those who suffered with an opioid use disorder (OUD).

I currently oversee a Suboxone program, have previously worked in a large methadone program, and have seen firsthand the benefits of these medications on people of all ages, from adolescents to grandparents. But I don’t believe enough discussion has been given to the rest of the treatment. Just what treatment does the medication assist?

First, it is important to understand that that people with an OUD typically have very complicated and often terribly disrupted lives. Opioid addiction hijacks not only the brains of these people; it causes a neurological disorder, and usually steals what is most precious: their lives.

Powerful addictions can cause a person’s life and strongly held priorities to be overturned in a very short period. Relationships may be ruined due to ruptures of trust, broken promises, outright deception or egregious behavior. The sad reality is that the substance often unintentionally becomes more important than partners, children, parents, siblings, and friends.

Finances are often seriously damaged or even destroyed in the need to quell the burning desire for another “fix” or to blunt the ever-present withdrawal symptoms always lying in wait. Employment issues become rampant, jobs are frequently lost, and paychecks become either inconsistent or just a memory.

For those struggling with addiction who have children, parenting often becomes inconsistent and less attentive, and parent-child relationships become less securely attached. Addiction exerts a terrible price on the addicted, those they love, and those who love them.

Medication primarily assists with the therapeutic counseling that should accompany its use. While the medication stabilizes the physical symptoms of addiction, which is a very important part of treatment, counseling helps the person rebuild their life.

An experienced counselor will allow the person to explore mistakes s/he has made, own his/her responsibility for injurious behavior, develop good self-care, rebuild dependable work habits, and pull him/herself up from financial quagmires. A well-trained counselor will educate addicted individuals about the addiction process, help them work through shame and self-loathing, and teach skills such as anger management, building healthy relationships, and how to maintain a strong and stable recovery.

Once recovery has been initiated and some stability achieved, the skilled counselor will help the individual address important medical issues that had been ignored including high blood pressure, obesity, chronic pain, or Hepatitis B and C.

In addition, individuals need to resolve deeply ingrained negative beliefs about themselves and the world. For many, traumatic events from the past are often lying in the undergrowth behind the addiction, and their resolution greatly improves the person’s quality of life.

It has been my privilege to see countless people engage in MAT, and many make dramatic recoveries. I have witnessed marriages saved, family ties rekindled, financial stability achieved even after bankruptcy, jobs not only preserved but promotions obtained, and businesses thrive again after years of decline.

I sometimes run into former clients with a smiling child in tow or who ask if they can show me a wedding or family picture. They are clearly proud of their recovery and appreciate all they have recovered.

Treatment works. MAT works, and not just because of the medication, but because of the essential counseling that should always be attached. We need more MAT services because less than 20 percent of those with an OUD receive treatment. We also need to help those who need these services receive the treatment they deserve.

Please support addiction treatment whenever you have the opportunity and help others remember that medication assisted treatment is much more than just filling a prescription. It is the opportunity to achieve recovery; that is, to recover what one has lost from their addiction and live a more satisfying and productive life.

Dan Johnson, PhD, is the Executive Director at Acadia Family Center in Southwest Harbor.


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