In the past couple of years there has been a shift in treatment that allows for non-abstinence-based interventions when they are deemed necessary by a medical professional. Prior to the adoption of these maintenance-based interventions (MBI), the addiction recovery culture was rather dogmatic in their insistence that any intervention that did not tout abstinence as the only reasonable approach to recovery was at best, misguided, and at worst, enabling. Our discussion here today will not be taking a side as to whether or not maintenance-based treatment approaches are appropriate or not, but rather it will be an examination as to if and when these interventions might be in the best interest of the addict. Before we begin to make distinctions between these two approaches, let’s unpack exactly what MBI are. As an example, a chronic opiate addict with a history of many relapses might be seen as a candidate for suboxone maintenance. Suboxone is chemically structured in a similar way to opiates so that it produces some of the same effects, but also acts as a blocking agent so that in the event opiates are ingested, chemicals within the suboxone work to block the receptors in our brain from receiving them, essentially rendering the drug useless. The problem that opponents to MBI is that they are concerned with the positive feelings that are produced by the suboxone and view it as a cheap way out of the actions required in an abstinence-based program.
There are some extreme cases where it makes sense that maintenance ought to be the preferred treatment approach; these cases are characterized by individuals who have never had any kind of long-term success within abstinence-based approaches ABA). This is where the topic becomes a little sticky because on one hand, proponents of ABA would argue that the individual has simply not yet accepted the reality of their predicament and then taken the actions steps necessary to begin harvesting a solid recovery program. Now on the other hand, proponents of MBI would argue that too much emphasis is being put on the failure on the part of the individual and instead of trying the same approaches over and over again, it would advantageous to employ new techniques such as MBI. Ultimately, this decision will be left to the addict and the medical provider they are working with, but in the meantime, it would be remiss of the addiction community to not engage in dialogues about this issue that will provide more clarity and understanding for those who need to make this decision.
Tree House Recovery of Portland, Oregon is a men’s addiction treatment center that teaches our clients how to roll with life’s punches and use the tools they’ve learned throughout the treatment process to stay on top of anything life throws at them. Call (503) 850-2474 to see how we can help you today.