Addiction is a chronic medical disease that is both treatable and preventable. However, due to persistent myths and stigma around substance use disorders, many people experiencing addiction are too ashamed to seek out support and treatment that will help them feel better. Many of these myths can even lead affected people to think that addiction treatment isn’t for them. Few would deny that a person with a chronic condition like diabetes or heart disease needs medication to manage their condition so they can feel better, and the same is true for many people experiencing addiction—medication can give them their lives back, helping them enter and stay in recovery long-term.
To help counter these misconceptions, we’re breaking down five of the most common myths about medications used in addiction treatment and sharing the evidence-based facts.
Myth: Medication for Opioid Use Disorder (MOUD) just “trades one addiction for another.”
Fact:
The American Society of Addiction Medicine (ASAM) defines addiction as a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to the characteristic biological, psychological, social and spiritual manifestations of addiction. As a result, people use a substance compulsively and continue using it even when there are negative consequences in their life. People with addiction often experience overpowering urges or cravings to use a substance, as well as withdrawal symptoms when they stop using. Withdrawal symptoms are extremely unpleasant and have potentially dangerous physical and psychological effects. Both cravings and withdrawal contribute to cycles where people continue to use a substance and cannot stop.
Medications for opioid use disorder such as buprenorphine or methadone work in the brain to treat cravings and withdrawal symptoms. These medications do NOT cause patients to feel “high” or “intoxicated” or “euphoric.” The goal with MOUD treatment is for patients to feel normal so they can live a functional life – breaking the cycle where cravings and withdrawal symptoms dominate their life.
Myth: There is no proof that Medication for Opioid Use Disorder (MOUD) is better than abstinence.
Fact:
Not true! Studies have consistently shown that people with Opioid Use Disorder will return to using opioids about 90% of the time when they do not receive medication treatment and try to stop “cold turkey.”. This happens even for people who go through “detox” in a hospital or rehab program. Nine times out of ten, people will return to using opioids within one to three months. In contrast, studies have consistently shown that patients treated with buprenorphine or methadone have much lower rates of returning to using – between 40% to 50%. This is a huge improvement!
Studies have also shown numerous other benefits to medications for Opioid Use Disorder. Patients are more likely to stay enrolled in a treatment program, less likely to be incarcerated, and less likely to acquire infections from drug use (such as HIV or Hepatitis C). Pregnant people treated with medication for Opioid Use Disorder are less likely to have pregnancy complications. Most importantly, people treated with methadone and buprenorphine are less likely to overdose and less likely to die. In summary, there is ample proof that treatment with MOUD is better than abstinence and it helps save lives.
Myth: There are no medications for the treatment of Alcohol Use Disorder.
Fact:
There are three medications that are FDA approved for treatment of Alcohol Use Disorder: Naltrexone (available as a daily pill or a monthly injection), Acamprosate, and Disulfiram. Naltrexone and Acamprosate both reduce the risk of returning to drinking and are generally well tolerated with minimal side effects. Other medications – such as Gabapentin and Topiramate – are not FDA approved for Alcohol Use Disorder, but there is a growing body of evidence that they may be effective.
Myth: If I can just get through withdrawal, I will be able to stop using the substance.
Fact:
Addiction is a primary, chronic disease of brain that is not resolved when patients go through the phase of acute withdrawal. The changes occurring in the brain and body that cause the illness may take months or even years to return to normal. In the meantime, people may be triggered by other people, places, objects associated with use, emotions, or other experiences. The urges and cravings that drive a person to want to return to using substances may last years despite abstinence.
Myth: There’s no need for long-term medication for addiction treatment.
Fact:
When it comes to treating substance use disorder, there is no “one size fits all” road to recovery. Stopping treatment too soon increases the risk of return to use. We recommend that each person’s treatment course be based on their individual needs and with shared decision making with their health care provider. Due to the chronic nature of substance use disorders, the need for continued medication treatment should be periodically re-evaluated. Just like those with other chronic conditions like hypertension or diabetes, some people with the most severe substance use disorders may require lifelong treatment with medications.
If you or someone you know is experiencing a substance use disorder, the University of Michigan Addiction Center has resources to help.
