Understanding Medication to Treat Opioid Use Disorder for Treatment Court Participants

What is the treatment plan?

After discussing the assessment and treatment choices, it is time to finish your treatment plan. It is common for both you and someone from the team to sign an agreement about what to expect during treatment. This can include treatment goals, which medications are used, treatment and visit schedule, and counseling plan.

The treatment plan may also include:

• Counseling groups and individual sessions with a counselor or therapist
  • While counseling will be required while in treatment court, it is not required before you start medication for opioid use disorder. Medication for opioid use disorder can begin before, after, or at the same time as counseling.
• Other mental or physical health needs for which additional medications may be necessary
• Commitment to actively participate in treatment
• Help to prevent and manage returning to use and other safety concerns
• Assistance with housing, jobs, and other life needs

When I start treatment, what is expected of me?

• Treatment or other recovery support will be ongoing, as addiction is a chronic disease. For this reason, you will need to discuss and agree to a treatment plan. The treatment plan should be revisited at various points in your treatment, just as you would with any other chronic illness. You will continue to see the medical provider and participate in counseling, mutual help groups, and other recovery supports based on the agreed-upon treatment plan.
• Expect to be treated with respect and dignity. Your concerns should be considered when starting or changing the treatment plan.
• Common participant responsibilities include:
  • Keeping all your appointments
  • Agreeing to drug testing on a regular basis
  • Taking medications as prescribed
  • Not using any nonprescribed drugs, and if you do, admitting that you have
  • Allowing and encouraging involvement of family and friends

Who needs to know that I'm taking this medication?

• The nurse or doctor providing your medical, mental health, or pain management care should know that you are being prescribed medications for opioid use disorder.
• The treatment court counselor or supervision officer will also need to be informed that medication has begun.

How long is medication treatment?

As with medication for other illnesses that need ongoing treatment like diabetes, hypertension, asthma, schizophrenia, and bipolar disorder, there is no “right” amount of time to take medication for opioid use disorder. Some people will eventually taper off medication. Others will continue to benefit from medication for many years.

How can counseling help?

Counseling can help you:

• Connect with others dealing with addiction and recovery.
• Address life issues that may contribute to or result from your addiction.
• Deal with difficult situations at work or home.
• Manage stress.
• Learn skills necessary to begin and maintain recovery, health, and wellness.
• Confront feelings of inadequacy, guilt, or shame.

While counseling may not be required to maintain your medication, full participation in counseling is required to remain in and successfully complete treatment court. It is important to remember that counseling does not prevent opioid withdrawal and may not be enough to prevent a return to use or death in those living with severe opioid use disorder. This is why medications are an important part of the treatment plan.

How can my family and loved ones help?

• Family members and supportive friends can educate themselves, as they play a key role in enhancing your chances of a long-lasting recovery.
• It is helpful if they remember that places, people, and events associated with addiction may contribute to a return to use. They can help you avoid some triggering situations. For example, they can help by keeping alcohol or drugs out of your presence.
• Sometimes addiction leads us to do things repeatedly that disappoint, harm, anger, or frighten our loved ones. Eventually, we must accept and acknowledge responsibility for that. It may take them time to trust you again. Be patient with them and stay on your recovery journey. If they are not able to give you the support you need right away, find others who can connect with you, encourage you, guide you, and help you keep the promises you make to yourself.
• Your loved ones may need to seek their own counseling and support.

How do I address my use of medication with my peer recovery support group?

• You can speak about medication for opioid use disorder with the group by:
  • Offering this guide to help a member understand better what medications you are taking and why.
  • Talking it over with a sponsor who understands that medications in addiction and mental health treatment may be necessary to establish recovery.
  • Talking it over with a counselor to get support.
• Peer support groups are to be a “safe space” for people who are seeking recovery from addiction. Hopefully, your peers will understand the use of medication to treat addiction and support recovery. If not, you may need to seek out a support group that does understand this.
• You are not required to disclose your use of any medications to your support group if you choose not to.

What should I do if I return to use?

• Your counselor should work with you to develop a plan to prevent and manage a return to use. The plan should include everything you should do if you use again—even once.
• Talk about it right away with someone in your support network and on your treatment court team.
• Show up for drug testing even if you will likely test positive. Admit that you have used even before you are tested.
• This is not a failure. Many people get off track, survive it, and get right back on the road to recovery.
• Continue to work with your counselor and doctor on your treatment plan; together, you may decide to make some changes to prevent further returns to use.