How Opioid Agonist Therapy Reduces Self-Harm And Suicide Risks

Opioid agonist therapy is an effective treatment for opioid addiction and lowers risks of self-harm and suicide. This treatment works by reducing withdrawal symptoms and cravings and incorporating mental health treatment, such as therapy and relapse prevention skills.

Reduction In Self-Harm Through Opioid Agonist Therapy

Opioid agonist therapy (OAT) uses opioid agonist medications, such as methadone and buprenorphine (Suboxone), to prevent withdrawal and reduce cravings for opioids.

Researchers have found OAT to be an effective treatment method for opioid addiction, significantly reducing the risks for self-harm and suicide for people coming off of opioids.

This treatment used in combination with therapy, peer support, and other psychological support is one of the best ways to treat opioid abuse.

What Research Says About Opioid Agonist Therapy And Self-Harm

Research surveying nonfatal self-harm and suicide hospital admissions from 1998 to 2018 revealed important findings about the effectiveness of OAT in reducing these risks.

The results showed the following:

  • when off OAT, clients’ risks for suicide and self-harm increased significantly
  • risk for self-harm more than doubled in the first four weeks after stopping OAT versus stable periods on treatment, and risk for suicide more than quadrupled during this time
  • no statistical significance was found between the effectiveness of methadone maintenance and buprenorphine used in OAT, meaning both are sufficient treatments

Risks Of Opioid Agonist Therapy

While this study shows the growing evidence for OAT as a means for treating opioid use disorder and preventing self-harm and suicide, the treatment is not without risks.

Researchers found that when OAT was stopped suddenly and after a short period, clients experienced negative repercussions, potentially increasing their risk of overdose and self-harm.

However, these researchers note that the best way to avoid these consequences is to extend the opioid agonist therapy treatment to two years, allowing sufficient time for treatment.

The month following OAT cessation is a vulnerable time for relapse and self-harm. It’s important that a client using this treatment be in a stable condition and follow up with mental health professionals.

What Is Opioid Agonist Therapy?

OAT is a form of medication-assisted treatment for heroin and opioid addiction.

How Opioid Agonists Work In The Brain

An opioid agonist is a drug that activates the opioid receptors in the brain. Examples of these medications include methadone, a full opioid agonist, and buprenorphine, a partial agonist.

Other forms of MAT use opioid antagonists, which block the effects of opioids by attaching to the opioid receptors without activating them.

An example of this medication is naltrexone for treating opioid addiction. If a person uses an opioid such as heroin while on naltrexone (Vivitrol), the medication will block the effects and prevent the feeling of getting high.

The medications used in OAT are long-acting, meaning they dispense slowly over a period of 24 to 36 hours or more to prevent withdrawal.

Opioid addictions to stronger substances, such as oxycodone addiction or fentanyl addiction, involve short-acting opioids, which produce the feeling of getting high.

How Opioid Agonist Therapy Works

The medications will help to manage pain and uncomfortable withdrawal symptoms so you can better focus on your mental and physical healing moving forward.

You’ll likely take the medication in a daily or weekly dose, depending on your provider and the dose of the medication. This will help to stabilize your body and keep cravings down.

The other key component to OAT is looking after your mental health. The use of medication should be combined with therapy to prevent relapse and address the root issues of the addiction.

Your program might include:

  • individual counseling sessions
  • group therapy
  • relapse prevention groups
  • self-help groups, such as 12-step addiction treatment programs
  • peer recovery mentors
  • family therapy
  • life skills development, such as education, vocational, and financial literacy assistance

How Opioid Agonist Therapy Prevents Suicide And Self-Harm

By working with addiction clinicians and mental health professionals, clients using OAT receive necessary care for their physical and mental health that prevents suicide and self-harm.

Reduced Physical Complications Of Withdrawal

OAT significantly reduces the possibility of experiencing extreme withdrawal symptoms (such as abdominal cramping, diarrhea, and life-threatening effects).

These withdrawal symptoms can often lead to psychological distress, causing a person to self-harm or consider suicide as mental health issues worsen with the distress.

Additionally, the above study notes that official suicide rates may not be entirely accurate, as it’s difficult to know whether an overdose is intentional.

Using OAT helps to prevent these overdoses from occurring by stabilizing physical symptoms of opioid withdrawal so people using OAT are less likely to experience negative mental effects.

Reduced Symptoms Of Mental Health Issues

OAT also promotes long-lasting sobriety and mental wellbeing with a number of therapeutic approaches forms of support.

Components such as behavioral therapy, family support, community involvement, education, relapse prevention skills, and more are built into the structure of OAT to improve mental health.

When clients see that recovery doesn’t have to be painful or inevitably lead to relapse, they have reduced symptoms of anxiety, depression, and other mental illnesses that can cause self-harm.

Other support related to education, vocational training, and life skills development can also help people using OAT to overcome barriers and challenges tied to substance use.

Find Treatment For An Opioid Addiction

If you or a loved one are overcoming an addiction to opioids, several treatment approaches can help, including opioid agonist therapy.

To find more information on treatment for opioid addiction, call our helpline today and we can make a referral to a rehab program or MAT facility.

The American Journal of Psychiatry Residents’ Journal 10 — Recurrent Foreign Body Ingestions Following Rapid Methadone Taper: Neurological Aspects of Self-Injury and Opioid Therapy - https://psychiatryonline.org/doi/pdf/10.1176/appi.ajp-rj.2017.120304

Centre for Addiction and Mental Health — Opioid agonist therapy - https://www.camh.ca/-/media/files/oat-info-for-clients.pdf

Indian Health Service — Pharmacological Treatment - https://www.ihs.gov/opioids/recovery/pharmatreatment/

Medscape — Opioid Agonist Therapy Guards Against Self-Harm, Suicide - https://www.medscape.com/viewarticle/965673#vp_2

Psychiatric Research Institute (PRI) — What Is Naltrexone? - https://psychiatry.uams.edu/clinical-care/cast/what-is-naltrexone/

Substance Abuse and Mental Health Services Administration — Naltrexone - https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/naltrexone

U.S. National Library of Medicine: MedlinePlus — Opiate and opioid withdrawal - https://medlineplus.gov/ency/article/000949.htm

U.S. National Library of Medicine: MedlinePlus — Opioid Misuse and Addiction - https://medlineplus.gov/opioidmisuseandaddiction.html

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