Opioid Maintenance Therapy and Complete Recovery

Substance use disorders are associated with increased risk of criminal activity, and this is particularly true in the case of heroin addiction. One of the many benefits of opioid maintenance therapy, or opioid replacement therapy, is that initiation of such treatments is associated with decreased levels of criminal activity.

However, a recent open cohort study published by the Journal of Substance Abuse Treatment indicates that not all OMT patients reduce or abandon their criminal activity. To truly treat the disease of addiction, the hope is that patients’ lives will improve such that criminal activity is no longer desirable or necessary. Decreased criminal activity on OMT is an important indicator for the success of the treatment. Examining factors that could negate that effect is important for improving OMT outcomes among those recovering from substance use disorders.

The risk factors found by the study were divided into the following subcategories- drug-use related, psychosocial, and demographical. Over a quarter of the population surveyed was involved in criminal activity at least once over the five-year study period. Risk factors found in the study include being a male, and use of non-prescribed stimulant medications. Additionally, patients on Buprenorphine showed higher levels of criminal engagement than did those on methadone treatment.

The problem with risk factors that lead to criminal activity in this case is that they are difficult or impossible to modify. The real value in this study lies in the inverse of the original question: what factors lead to decreased criminal engagement?

The results are simple. Three major keys to decreased criminal activity are having stable living conditions, having a job, and being a student. The implications of this study are clear: chemical treatment without social rehabilitation is not complete.

The goal of substance use disorder treatment should not just be to keep people alive, but to help them achieve a high standard of living and quality of life. That is what recovery truly means. Even as we focus on detox, and on therapy sessions, and on avoiding triggers, it is vital that recovering addicts learn to recover their lives. Treatment centers can play a key role in this type of recovery by facilitating clients to find employment or enroll in school and ensure safe and stable housing.

Staying connected with alumni should include tracking these factors. Housing, education and employment are the foundations of a successful life, and are therefore, the goal of recovery.