Recovery, Not Maintenance: Why CORE Is Opioid Free
Over the past decade, the treatment of opioid addiction using methadone and buprenorphine has expanded rapidly across America. As overdose deaths surged, particularly with fentanyl saturating illicit drug supplies, policymakers have adopted a clear priority: to keep people alive. In response, treatment strategies increasingly emphasize immediate mortality reduction over longer-term recovery models.
Using opioids to treat individuals addicted to opioids, known as Medication Assisted Treatment, or MAT, has become a multibillion-dollar industry, funded largely by the federal government.
From the perspective of an addict, the appeal of MAT is easy to understand. Prescribed opioids prevent withdrawal, which is terrifying, and eliminate the constant fear of becoming sick. MAT feels safer than street drugs, especially when one bad batch can be fatal. Drug use sanctioned by a physician also carries a sense of legitimacy and allows life to continue without much disruption. For most, the cost of using is covered entirely by government funding.
Not everyone, however, finds this vision satisfying. There are those who want something more than chemical stability. They want to recover.
This group recognizes that drugs have destroyed their lives. They want to be done with substance use entirely. Their desire is freedom without qualification. Freedom from cognitive dulling, emotional flattening, chronic constipation, gut dysfunction, and sexual dysfunction. Freedom from living dose to dose. Freedom from managing, monitoring, or controlling substance use. Their hope is for a life in which opioids are no longer relevant, where there is no compulsion to use and no daily effort to avoid withdrawal. They are not interested in replacing one opioid with another. They want complete liberation.
In southwest Missouri, the treatment landscape is becoming increasingly crowded with MAT providers. Government funding is frequently conditioned on a favorable disposition toward these prescription opioids.
For individuals seeking freedom, there is CORE. CORE offers the evidence-based Twelve Step model recognized by medical authorities as one of the most effective approaches to achieving sustained abstinence, performing as well as or better than other established treatment models.
Because CORE is committed to an evidence-based approach to treatment, we are sometimes asked why our program is still opioid free. Our answer is simple: we are a recovery program. Our work is not limited to harm reduction, which is already well represented by programs that dispense and accommodate opioids. While harm reduction focuses on minimizing damage, recovery goes further. Recovery is about transformation and new life.
There is no freedom in continued drug dependence. Under MAT, a person’s life still revolves around opioids. Decisions are still made about dosing, timing, and access. Legal opioids become the solution to illicit ones. The delivery system may change, but the relationship with drugs does not. The obsession has not been lifted. A chemical is still required to make life tolerable.
Contrast this with CORE, where recovery is real and clients are oriented toward the life they are meant for. Our clients learn to live without any chemical mediation or crutches, making our aim fundamentally different from MAT programs. CORE offers hope grounded in the reality that people do recover, unmedicated, unmanaged, and unafraid. They are no longer chained to drugs.
CORE offers liberation, where clients learn to live happy, joyous, and free without symptom control, risk mitigation, managed dependency, or chemically assisted stability. Recovery means freedom without asterisks. It is peace that does not come from sedation, hope that does not require an opioid prescription, and joy that does not disappear when the supply runs out.
A recovered individual has no need for chemical management. He wakes each morning without a baseline drug requirement. His emotions rise and fall naturally. Joy, grief, excitement, and boredom are all felt as they come. Life is no longer planned around a substance or tethered to a prescriber. There is freedom, and with it, the real world, full of possibility.
CORE is proud to continue its tradition as a recovery program, which remains the only viable approach to attaining an emotionally mature, fully realized life. Knowing freedom ourselves, we cannot in good faith offer a program that revolves around daily opioids. We have experienced the lifting of the obsession, unmediated emotional lives, unqualified peace, and the ability to face each day without substances. Having been blessed with this miracle of recovery ourselves, we will not present anything less to clients looking for real help. Our staff knows all too well the shortcomings of being caged in chemical dependency. We will not romanticize cages in order to obtain government funding.
We recognize that individuals arrive at different points of readiness and with different needs. For some, MAT serves that purpose. We do not seek to prescribe treatment approaches for everyone. CORE exists to provide recovery to those want to live without chemical management, and we are honored to fulfill this role.