With more and more Idahoans falling victim to opioid addiction, we're taking an inside look at one replacement therapy option available right here in the Treasure Valley.
In Idaho, there are only two businesses that offer Methadone-based Medication-Assisted Treatment programs -- each with two locations -- and all four options in the entire state fall between Boise and Nampa. As a result, some people are driving to the Treasure Valley daily from as far as Oregon and Pocatello in their mission to conquer addiction.
Roughly 300 patients a day walk through the doors of Raise the Bottom Addiction Treatment Center in Boise - A Medication-Assisted Treatment option often referred to as MAT. Patients include men and women of all ages fighting back against their addiction to opioids like heroin and prescription painkillers.
"Addiction isn't prejudiced at all," Raise the Bottom executive director Jason Austin said. "People stigmatize addiction as if it's a low [class] thing and it's not."
Once an in-house doctor diagnoses an opioid dependency, patients will begin receiving one of three FDA-approved medications to fight against the symptoms of painful withdrawal.
"You have receptors in your brain and they are craving these opiates, so methadone covers those receptors so they are no longer craving those outside opiates," Austin explains. He says the beauty of Methadone is its ability to block those receptors without making a patient high, allowing them to live their lives without worrying about where their next fix will come from.
"That hopelessness, fear, and desperation - I think that's one of the most important things you see that disappears," Austin said. He says typically, a major mental difference is noticeable within the first week of treatment.
"They're starting to see there's a light at the end of the tunnel because it's, 'Alright, I come here once a day, I continue to get this medication, I don't have to spend the rest of my day calling up my dealers, trying to meet them here, figuring out where we're going to do this, where am I going to get my money to buy this, or what am I going to do in lue of money to buy this?'" Austin said.
Although they carry three treatment options - liquid Methadone, dissolvable Suboxone tablets, and a monthly shot called Naltrexone - most patients start with a low daily dose of Methadone.
"We make sure that it's liquid, so they can swallow it in front of us and then talk back so we know they've taken the medication and they're not going to go divert the medication in some way," Austin explains.
Some patients may eventually limit their clinic visits by switching to a take-home dose of Suboxone or Methadone after proving certain criteria and meeting federal guidelines.
"We don't just hand it to the first person who walks in and says, 'Oh, I want Suboxone,'" Austin said "They might not be a safe patient to have a prescription."
The ideal goal is for each patient to eventually reach abstinence and no longer need MAT, but depending on how long and how heavily they've been using opioids, some patients may very well remain on a low dose of Methadone for the rest of their lives.
"Just like taking medication for diabetes," Austin said. "There's no difference."
The treatment center is trying to shake the stigma that they're just replacing one drug for another. "Why would we treat someone with addiction different than somebody with a different disease like cancer or Parkinson's?" Austin said. "They didn't ask for this disease."
But medication isn't all they offer. Their staff of 37 - including nurses, doctors and therapists - offer counseling and group therapy sessions.
"The real change in someone's life is when they start the therapy side of things," Austin said. "We do relapse prevention meetings, or other topics depending on the need at the time.
We do pregnancy groups, anxiety groups."
It's therapy Austin says leads to major behavioral breakthroughs. "Because our patients are here, they're not stealing; they're not fighting, they're not dealing drugs anymore. They are treating people differently; they're going to school, they're not engaging in criminal activity."
And before you assume the government is picking up the $300-a-month price tag, Austin says they don't receive any federal funding. "It's all either cash pay, insurance or Medicaid. But on the flip side, the state is paying for their Medicaid to come here, rather than going to the E.R. 10 times in a year."
All MAT patients at Raise the Bottom are subject to drug tests carried out in their in-house lab. Clinic leaders say another added perk of MAT is that patients stop using IV drugs, lowering their risk of contracting or spreading infections, H.I.V. or Hepatitis C.