Medication-Assisted Treatment (MAT)

Medication-Assisted Treatment (MAT) is one of the safest and most effective methods for helping people recover from opioid addiction. Standard addiction treatment programs mainly consist of counseling and behavioral therapy programs.

Medicated Assisted Treatment goes a bit further. MAT utilizes FDA-approved medications comprehensive therapy, and behavioral counseling to provide an integrated approach to treating opioid dependence.

By using this holistic approach to treat this particular addiction, patients no longer have to worry about withdrawal symptoms and relapsing, but only focus on their journey to sobriety.

Medication-Assisted Treatment for Opioid Addiction

America is facing an opioid epidemic. In 2018, approximately 48,320 people died from opioid-related overdoses. The need for affordable and accessible opioid treatment for individuals and communities struggling with heroin and pain killer addiction has never been more urgent.

Opiates are a group of drugs known to have a high risk of addiction and dependence. These include prescription pain killers such as Oxycontin, Vicodin, and Codeine, and illegal drugs such as heroin and fentanyl. Individuals addicted to these drugs feel sick when they are unable to use their drug of choice.

Opioid withdrawal symptoms may include:

• Nausea
• Vomiting
• Joint pains
• Chills
• Diarrhea
• Crumps
• Anxiety
• Insomnia

Other than the withdrawal symptoms, addicts also experience intense cravings, which makes long term recovery more difficult to attain. Medications used in the MAT program help to reduce cravings and withdrawal symptoms; therefore, they help patients to focus on returning to their healthy lives.

The medication used in an opioid treatment program works in one of two ways. The first technique involves doctors using FDA-approved medicines that take longer to get absorbed into the bloodstream, thus staving off withdrawal symptoms. The second involves the use of non-opioid drugs (opioid antagonists) to block opioid receptors in the brain so patients don't get high if they relapse.

Common Medications Used in Medication-Assisted Treatment

Only FDA-approved medications, prescribed and distributed by an addiction recovery nurse, are used in MAT programs. Currently, there are only three medications used for MAT treatments.

Here is a list of medications used by doctors in Medication-Assisted Treatment for Opioids:

• Naltrexone (Vivitrol) - Vivitrol is an FDA approved injectable antagonist that works by blocking the effects of opioid medication. Naltrexone attaches itself to opioid receptors in the brain; therefore, creating a barrier that prevents opioid molecules from attaching to receptors.
  
  The once a month injection helps prevent the risk of opioid overdose due to its blocking effects and discourages patients from relapsing back to opioid dependence because they will not get high. Before using Naltrexone, patients undergo a thorough detox to rid their system of any opioids.
  
  Doctors can also use Vivitrol injection to treat alcoholism. Vivitrol reduces a person's urge to drink, making him or her drink less or stop drinking. Like heroin, patients should have abstained from alcohol for two weeks before their first Vivitrol injection.
• Suboxone (Buprenorphine) - Suboxone is an FDA approved prescription drug which comes in the form of a pill or a film which is placed under the tongue or in the buccal cavity.
  
  Comprised of Buprenorphine, a partial opioid agonist and Naloxone, an antagonist, Suboxone works by alleviating physical withdrawal symptoms and decreasing the craving for opioid-medications. Unlike Vivitrol, which only numbs the brain from the effects of opioids or alcohol, patients on Suboxone experience can experience sickness if they use opiates while on the medication.
  
  Suboxone, however, comes with a risk of dependency due to the presence of opioid molecules. It should only be used under strict prescription. Pregnant women are also not advised to use Suboxone as it may cause opioid dependency in the newborn.
• Methadone - Methadone is the most well-known and used medication for treating opioid addiction. This FDA approved long-acting full agonist works by binding itself to opioid receptors of the brain and produces similar effects to heroin and narcotic pain killers.
  
  Taken once a day, methadone reduces opioid cravings and helps with withdrawal symptoms. By providing similar but longer-lasting effects as opioids, patients using methadone can go back to their normal lives. However, since methadone is an opioid, it can easily be abused. To avoid switching one addiction for another, only use methadone as directed by a physician.
  
  Unlike Suboxone and Vivitrol, pregnant women can safely take methadone. It's important to note that each of these drugs is used together with comprehensive therapy, family counseling, and continuous support.

How Do Doctors Decide the Best Medication to Use?

What works for one patient may not work for another. Therefore, doctors create a personalized recovery plan for every patient. Doctors will consider the risk and benefits of each medication before prescribing it. Patients with a higher risk of overdosing are put under Suboxone since they can't overdose on this.

Patients who need surgery are also put under buprenorphine since its easier to wean down the dose. However, for pregnant women, methadone is often the best option. The choice of the best medication depends on the physician's interaction with the patient.

How Effective is MAT for Opioid Addiction?

Despite the controversy, research proves that medication-assisted therapy is the most effective method for treating addiction. This treatment method is most effective when it is used in conjunction with other behavioral health therapy.

The Substance Abuse and Mental Health Services Administration explains that the MAT approach results in:

• Increased ability for a patient to get and hold employment
• Improved birth outcomes in women who have substance abuse disorder while pregnant
• Decreased risk of relapse
• Reduced overdose cases.

A ten-year study conducted in Baltimore found that the use of Buprenorphine in MAT programs resulted in a significant drop in heroin and narcotic painkiller overdose. A 2014 study concluded that Methadone use resulted in improved outcomes in patients with opioid addiction disorders.

Counseling and therapy also play a crucial role in the effectiveness of MAT programs. The 12-step meetings, individual and group counseling, and community resources help to ensure patients are supported continuously through their recovery journey. And if that's not enough, MAT also facilitates family and community counseling to ensure patients have a healthy support system of their family, friends, and peers.

Medication-Assisted Treatment for Alcoholism

Like opioids, alcohol dependence can lead to life-threatening withdrawal symptoms. MAT can help to alleviate alcohol withdrawal symptoms and ease cravings to ensure a patient focuses on his/her recovery.

Here is a list of medications used by doctors in Medication-Assisted Treatment for Alcoholism:

• Disulfiram - Disulfiram will make you never want to drink again. Patients on disulfiram experience an unpleasant feeling when then they drink. This may include nausea, vertigo, vomiting, sweating, and heart palpitations. Patients who chose to use disulfiram should be dedicated and committed to achieving sobriety. Otherwise, they may relapse.
• Acamprosate (Campral) - Acamprosate doesn't relieve withdrawal symptoms. It works by stimulating the gamma-aminobutyric acid receptors in the brain to provide a calm and sedate feeling, which reduces the craving for alcohol. Acamprosate works best when accompanied by group therapy and is most useful for patients who've already stopped drinking.
• Naltrexone - Also used in opioid medication-assisted treatment, Naltrexone works by blocking the euphoric high that a person experiences when he abuses alcohol.

Common Length of Treatment

Medication-Assisted Therapy is not a quick fix. MAT is a lifelong recovery and rehabilitation process that entails the collaboration of medical staff and a willing patient. Patients can safely take MAT medications for several years or even a lifetime as long as they follow the physician's plan. However, there should be continuous discussions on developing a medication withdrawal plan. The success of a MAT program mainly depends on the patient's willingness to continue with their sobriety journey.

Therapy and Counseling

Federal law requires that all MAT patients receive counseling, education, and medical assessments as part of the treatment program. MAT patients have to undergo several one-on-sone therapy sessions with a counselor. Patients also undergo group counseling, which involves creating a comfortable environment to work out emotional issues.

Group counseling also provides positive peer pressure to abstain from substance use. The other pillar of the MAT program is community education. Currently, the opioid epidemic affects every group of people in the United States. Community education is meant to increase public awareness of the nature of opioid addictions and treatment options available.

Will My Insurance Cover Medication-Assisted Treatment?

Most insurance plans will cover this type of addiction treatment. The effectiveness of the MAT program has allowed many health care providers to cover this type of treatment service. Currently, over 16 insurance providers have committed to supporting patients going through MAT programs.

Find A Treatment Center for Medication-Assisted Treatment

Many addiction treatment centers within our Rehab Directory offer Medially Assisted Treatment. If you're looking to participate in a MAT program, there are many options within our directory. You can browse rehab centers by clicking Find A Rehab above.

Myths About Medically Assisted Treatment for Addiction

A common myth about MAT is that doctors are substituting one drug for another, creating an alternate addiction. To the untrained eye, MAT is merely substituting one opiate for another. But that's not the case. In the MAT program, Doctors replace dangerous drugs that will likely kill you, with non-dangerous medications that allow you to get back to a healthy lifestyle.

Although methadone can be easily abused, research shows that when used correctly, MAT medications have little adverse and long-term effects on patient's employability, intelligence, or physical functioning.