A port in the opioid storm

In that time, there have been 1,544 suspected opioid-related deaths statewide. And that number reflects national statistics; according to a 2016 Centers for Disease Control report, 116 Americans died of opioid overdoses each day.

Real-time data on Arizona’s opioid issues can be found at https://www.azdhs.gov/prevention/womens-childrens-health/injury-prevention/opioid-prevention/index.php.

As the country, the state and the Gila Valley continue to face an epidemic of prescription opioid and heroin addiction, a late July meeting in Safford explored the causes and effects of substance abuse and looked at one method of treating those affected by the opioid outbreak.

A daylong Medication-Assisted Treatment, or MAT, Symposium was held July 24 in the Graham County General Services Building. Staged by the Arizona Health Care Cost Containment System (AHCCCS) and the Arizona State University Center for Applied Behavioral Health Policy, the event presented addiction as a disease and provided attendees with information on MAT.

“There is an opioid addiction epidemic,” said Graham County Health Department Director Brian Douglas. “It’s been deemed a public health emergency in Arizona, and because of that, additional funding has come in to begin these medication-assisted treatment programs.”

Dr. Adrienne Lindsey, of the ASU Center for Applied Behavioral Behavioral Policy, described her presentation as “MAT 101.” Lindsey outlined how opioids and other drugs physically affect a user’s brain and gave an overview of the treatment, defined as “treatment for a substance use disorder that includes a pharmacological intervention as part of a comprehensive substance use treatment plan.”

This means using such medications as methadone, buprenorphine, naltrexone and Suboxone (a combination of buprenorphine and naloxone) along with behavioral therapy to treat those who suffer from addiction. According to a 2014 bulletin from the Centers for Disease Control and the Substance Abuse and Mental Health Services Administration, the combination of medicine and therapy is more effective than therapy alone.

MAT, which is offered by several Gila Valley providers, can aid substance abusers by easing withdrawal symptoms, reducing cravings and/or inducing illness when a substance is ingested. Its benefits include reduced substance use, lower overdose risk and increased employment rates.

The symposium also tackled some misconceptions that have led to underuse of MAT — that it simply trades one drug for another, is ineffective, is not needed by those who have gone through withdrawal and is too expensive.

Kathy Grimes, of the Graham County Substance Abuse Coalition, said the event helped educate the community and clear up those misconceptions. Grimes added that the goal was not to keep patients on MAT for their whole lives — that they should eventually be taken off those medications as well.

Lindsey’s presentation pointed out that such drugs as methadone are FDA-approved, regulated for potency, and prescribed and monitored by medical providers. Local MAT providers include Canyonlands Healthcare, SEABHS, Arizona Complete Care, Community Medical Services and Dr. Douglas Harrison, of Rex OBGYN.

As for the medicines’ reputed ineffectiveness, Lindsey cited studies showing that, in 24 clinical trials, buprenorphine was proved effective in reducing illicit opiate use; that methadone resulted in an eight- to tenfold decrease in opiate-related deaths; and that MAT reduced such risky behaviors as intravenous drug use and unprotected sex.

The symposium also countered perceptions that MAT is too expensive, pointing out that many of its medications are found in state Medicaid formularies. For example, in Arizona, the AHCCCS drug list includes methadone. They are also funded through state block grants, nonprofit organizations and private health insurance.