ALBUQUERQUE, N.M. — Dr. Leslie Hayes began working as a family doctor in Rio Arriba County when the area claimed the nation’s highest overdose rate.

That meant even though she was a primary care physician, she soon became an expert at treating addiction and a witness to astounding transformations.

“You get them into treatment and they’re completely different people,” she said. “They’re able to reconnect with their family, they’re able to get a job again, they’re able to take care of their children.”

Hayes said she reaches patients — some young, some old, some new users, some dealing with long-term addiction — with a combination approach. Medication-assisted treatment, or MAT, pairs resources like therapy, job skills training and housing with stabilizing medications.

Though the technique has gotten some pushback from critics who say it creates another addiction, Haynes said medical professionals administering the treatment disagree draw a line between physical dependence and addiction.

“Addiction means that peoples’ lives are spiraling out of control. They’re becoming more dysfunctional, and this is not true of methadone and buprenorphine,” she said. “People who are taking these medications become much more functional, much better able to live, to lead the lives that they want to live.”

Hayes said there are also differences in how treatments affect the body.

“There are several differences in the way they work,” she said. “When heroin or [oxycodone] go in, they go in very fast and they go out very fast. There’s this high peak and how quickly you go down really make people much more prone to addiction, whereas when buprenorphine or methadone go into the body, they go in very slowly, they stay in for a long time and they go out. As a result, people don’t have those ups and downs and they’re able to be very steady. They also don’t have the highs, so they don’t necessarily go out searching for these drugs.”

Hayes said some patients are eventually able to wean off. But for others, especially those who still have family members or neighbors using drugs, it’s not that simple.

“People want opiate use disorder to be like pneumonia. You treat them for 30 days. They’re better and it’s all done,” she said. “Unfortunately, that’s not true. It tends to be more like diabetes that people do tend to need long-term treatment.”

Hayes said the key is meeting people where they are, and treating them in a way that gives them the best possible chance at a high quality of life. That includes addressing the factors other needs. Community health and social workers work with her patients to address other factors in their lives that may have contributed to the development of addiction.