Medication Assisted Treatment (MAT) is the use of medications combined with behavioral therapies to help individuals recover from substance use disorder. Monitored by a physician, studies have proven that this form of treatment is one of the most effective methods to treat opioid addiction, compared to more traditional non-drug approaches.
The History of MAT
In 2000, the Drug Addiction Treatment Act (DATA) began allowing narcotic prescriptions to be used to treat opioid dependence in an outpatient setting. In 2016, President Obama signed the Comprehensive Addiction and Recovery Act (CARA), allowing nurse practitioners and physician assistants to become prescribers. And in 2017, more than 47,000 people in the United States succumbed to an opioid overdose including heroin, prescription opioids, and illegally manufactured drugs. In response to the crisis, increased demands for treatment and prevention were seen within treatment centers, medical clinics, and leaders across the nation. This created a more widespread acceptance and acknowledgement of MAT in the United States.
In 2018, the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act) was passed and expanded the ability of doctors and other medical professionals to treat patients with MAT, and that same year the American Medical Association recommended MAT as a groundbreaking approach to treat individuals with opiate use disorder. According to the Substance Abuse and Mental Health Services Administration (SAHMSA), today, nearly every state has an opioid treatment program that provides MAT services.
What Is Medication Assisted Treatment?
Combined with psychotherapy, education, and medication, MAT is an evidenced-based modality for those struggling with substance use disorder (SUD). Primarily used to to treat opioid use disorder, it can also be beneficial for those struggling with alcohol addiction. When an individual participates in MAT, specific medications are used to normalize brain chemistry and block dopamine receptors. This means that if a person were to drink while on these types of medications, they would not feel the same euphoric effects that a person would receive when taking a drink or a drug.
In addition, these medications can also help manage withdrawal symptoms and physical cravings to help decrease rates relapse and improve the overall wellbeing of those seeking recovery. Medication assisted treatment has no timeline and is also customizable to help meet the needs of each individual person depending on symptoms of the substance use disorder and severity of withdrawal. In addition, long as an individual is participating in psychotherapy and under the supervision of a physician, the treatment can be continued as long as needed. While there are many inpatient rehabs that provide MAT services, this type of treatment can take place in an inpatient or outpatient setting.
Numerous studies have done to back the outcomes of Medication-Assisted Treatment. These can include but not be limited to:
- Help create long-term recovery
- Reduce the risks of relapse
- Help individuals manage depression, anxiety, and substance abuse
- Improve quality of life
What Medications Are Used To Treat Opioid Addiction?
Buprenorphine
Buprenorphine, also known under the brand name Suboxone or Subutex helps curb opioid dependency. A partial opioid antagonist, this means buprenorphine can produce the same effects as opioids but create a lower risk of misuse and dependency. Buprenorphine can be prescribed in inpatient, outpatient settings, and is the only medication to treat substance abuse that can be prescribed directly from a Physician’s office. There is a
Methadone
Methadone is a long-acting opioid antagonist – meaning it produces similar effects to opioids. The purpose of methadone is to alleviate withdrawal symptoms and drug cravings and can also be taken to relieve severe chronic pain. Due to its habit forming properties, methadone is specifically administered at a methadone clinic on a set schedule. While methadone has mild effects, those attempting to stop treatment may find extremely difficult. It’s crucial to talk to a Physician if you are preparing to go off methadone treatment.
Naltrexone
Naltrexone is an opioid antagonist that blocks receptors in the brain. Most often used after an individual completes opioid detox, this medication can be taken orally or injected. Known under the brand name Vivitrol, the injectable version is a long-acting form of Naltrexone that blocks opioid receptors for one month at a time. When taken orally or through injection, this type of drug stops the euphoric effects that opioids provide. In addition, Naltrexone will potentially decrease an individuals tolerance to opioids. If an individual relapses under this medication, it can be extremely dangerous and life threatening and overdose may occur.
Medication-Assisted Treatment for Alcoholism
Alcoholism is a widespread disease that affects millions. According to the National Institute on Alcohol Abuse and Alcoholism, nearly 16 million adults and adolescents have developed a dependence on alcohol. In order to fully recover from the devastating effects of the disease, it can require an alcohol detox or individualized treatment plan that addresses both the root cause of the addiction and maladaptive symptoms and behaviors that have arisen. During the detox process, withdrawal can be severely dangerous and create fatal withdrawal symptoms. In response, Medication-Assisted Treatment for alcoholism is an alternative to traditional treatment programming.
Currently, there are a number of medications that are used to treat Alcohol Use Disorder in the United States. These medications include disulfiram, naltrexone, and acamprosate. However, there are also other prescriptions that may be used to ease symptoms presented by alcohol withdrawal including benzodiazepines or anti-epileptic medications that may calm delirium tremens (DTs) from severe withdrawal symptoms. The
Disulfiram
Disulfiram, more commonly known by its brand name Antabuse was the first medication approved by the FDA to treat alcohol use disorder. Disulfiram blocks dopamine receptors and interferes with the metabolic process of alcohol in the body. When taken, it prohibits the euphoric effects that happens when one ingests alcohol. When an individual uses alcohol while on disulfiram, extreme adverse side effects occur. Symptoms may range from mild to severe, however last as long as alcohol is present in the users body.
Acamprosate
Acamprosate, known under the brand name Campral is used in tablet form and administered two to three times a day after a person has completed alcohol detox. This drug helps restore functioning of the brain that may have been effected during active addiction and helps reduce and manage alcohol cravings. Most commonly, this drug has been known to be taken for at least a year, though recent studies have concluded that a shorter duration of time. Paired with psychotherapy and treatment, the medication also inhibits the brains neurotransmitters so that individuals no longer feel the euphoric effects when of alcohol.
Is Medication-Assisted Treatment Right For You?
It is important to note that Medication Assisted Treatment is not a cure for substance use disorder, but rather a way to recover from the effects of it. Backed by evidence, when paired with behavioral interventions, MAT immensely lessens the risk of relapse. This treatment method can also be extremely helpful for individuals that have been unable to stay abstinent for a long duration of time with other methods.
While there are no specific guidelines for those who can partake in MAT, when deciding if MAT is a path you may want to consider the following:
- The severity of your substance abuse disorder, the duration of time that you’ve been in active addiction, and what substance you’re currently addicted to.
- Co-morbidities including dual diagnosis disorders. Common to substance abuse disorders are mental health disorders. Oftentimes, MAT can be a beneficial when a person is experience a dual diagnosis as all aspects of the individual is addressed that include biological, psychological, social risk factors.
- The professional opinion of a medical professional should often be a large factor in deciding on whether or not to move forward with pursing MAT.
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