Opioid addiction changes the brain. That’s a given. But does MAT also change the brain? If so, how? A new study just might surprise you.
MAT and the Brain
Does Medication-Assisted Treatment do more than ease an opioid addict’s cravings and withdrawal symptoms? That’s the question researchers are determined to answer.
Among those researchers is Dr. Nora Volkow. Volkow is the director of the National Institute on Drug Abuse (NIDA). That makes her one of America’s most esteemed addiction professionals. It also makes the good doctor a heckuva respected researcher. So when she places a patient in one of the institute’s MRI labs, her readings are considered solid gold.
“People say you’re just changing one drug for another,” Volkow told NBC News. “But the brain responds differently to these [addiction] medications than to heroin. It’s not the same.”
The medications Volkow is studying are methadone, buprenorphine and extended-release naltrexone. Science has already made clear that the three medicines can effectively treat opioid use disorder (OUD). They also know that patients who stick with methadone or buprenorphine cut their chances of death in half. Now the National Academies of Sciences, Engineering and Medicine are exploring how to overcome barriers to that care.
This is essential work, especially considering that far too few of the 2 million opioid users who need anti-addiction medicine actually receive it.
It’s clear that opioid addiction changes the brain in ways that even when people quit can leave them vulnerable to relapse. It’s also clear that those changes lessen with long-term abstinence. But how best to help the brain bridge the gap between active addiction and complete abstinence?
Dr. Volkow’s theory: Medication-based treatment will help damaged neural networks start getting back to normal faster than going it alone. To prove it, she’s comparing brain scans from study participants who quit heroin thanks to methadone with active heroin users and people who are in earlier stages of treatment.
“Can we completely recover?” asks Volkow. “I do not know that.” But with MAT “you’re creating stability” in the brain. And that helps recondition it to respond to everyday pleasures again.
The challenge now is finding out how exactly MAT heals an addiction-damaged brain. And which addiction medication works best for which patient. That means finding enough people willing and healthy enough to have their brains scanned for science at the same time they’re struggling to quit opioids.
It also means eliminating the stigma of addiction.
Addiction is a brain disease. “[It’s] not a choice, not a personality flaw, not a moral failing,” said Dr. Jody Glance, an addiction specialist at the University of Pittsburgh Medical Center. Furthermore, not offering addiction medicines to someone who needs them “is like not offering insulin to someone with diabetes.”
It also means eliminating the stigma surrounding MAT.
The misperception that MAT is simply substituting one addiction for another is that both methadone and buprenorphine are opioids. But they are weak opioids. And they stimulate the dopamine system more mildly than stronger opioids such as heroin, morphine or fentanyl. Methadone and buprenorphine level out the jolts of addiction withdrawal, so there’s no high and less craving. And people may safely use them for years. Naltrexone, in contrast, blocks all opioid effects whatsoever.
ALEF applauds Dr. Volkow and NIDA, as well as every other addiction professional whose research is helping to spread the good word about Medication-Assisted Treatment. And we’re especially excited about the latest inquiries into MAT and the brain. The more people understand just how MAT works for those battling addiction, the more those battling addiction will be helped by MAT.