Your odds of conquering addictions are greater with long-term maintenance therapy that incorporates FDA-approved medications along with some form of behavioral therapy or counseling. This treatment method is known as medication-assisted treatment or MAT, and it helps you preserve recovery when dealing with addictions.
The Substance Abuse and Mental Health Services Administration (SAMHSA) characterizes MAT with the utilization of medications, in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to the treatment of substance use disorders (SUD).
MAT is highly beneficial during opioid addiction treatment, alcohol addiction treatment, and for patients with co-occurring disorders. This method of treatment significantly decreases the chances of a relapse and increases the chances of a prolonged recovery.
MAT’s ultimate goal is your full recovery and the ability to live a drug-free and independent life.
Medications Used During MAT
The U.S Food and Drug Administration (FDA) has approved a variety of medications to treat alcohol and opioid use disorders during MAT programs. These medications help relieve withdrawal symptoms and psychological cravings that cause chemical imbalances in the body.
The FDA has approved buprenorphine, methadone, and naltrexone for the treatment of opioid dependence. And Antabuse (Disulfiram), naltrexone, and Campral (acamprosate) for alcohol addiction treatment.
Medications prescribed during MAT help patients in many ways, including:
- Working towards normalizing your brain chemistry.
- Blocking euphoric effects of alcohol and opioids.
- Alleviating your physiological cravings.
- Normalizing your body activity without severe effects of the drug you are abusing.
Other Elements of MAT
Other than medications, MAT also comprises of several other elements, such as:
- Pharmacological counseling
- Coordination/integration of SUD treatment and other medical or psychological therapies
- Psychosocial resources and interventions
- Community-based educational interventions
MAT for Opioid Use Disorder (OUD)
The American Psychiatric Association (APA) defines OUD as a chronic lifelong disorder with serious potential consequences, including disability, relapses, and death. In 2017, more than 72,000 Americans died from drug overdoses, including illicit drugs and prescription opioids, causing the nation to declare opioid use disorder a public health crisis in 2017.
Withdrawal syndrome caused by opioid dependence generally leads to most relapses. However, medications utilized during a treatment program can help alleviate opioid withdrawals and significantly increase the effectiveness of treatment.
Successful, lifelong therapy to stay opioid-free involves long-term medication and counseling/ talk therapy programs. The three main medications used in MAT for OUD are:
Methadone (Methadose/ Dolophine): Methadone is a long-acting opioid that activates the same areas of your brain as the drug you are abusing without generating a high. This medication is used to help alleviate withdrawal symptoms during treatment.
MAT helps alleviate opioid withdrawal symptoms, such as:
- Sweating
- Chills
- Irritability
- Anxiety
- Cramps
- Insomnia
- Diarrhea
- Nausea
- Headaches
- Vomiting
Buprenorphine: This medication acts upon the same receptors as opioids do, but not as intensely. This medication helps reduce cravings in recovering patients.
Naltrexone: This medication helps block the effects of opioids. Patients who are on this drug cannot get high if they return to using opioids.
MAT for Alcohol Use Disorder (AUD)
MAT is also immensely helpful for managing AUD. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has defined AUD as a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences.
Disulfiram, naltrexone, and acamprosate are the most utilized medications in MAT programs for treating AUD. These medications are not a cure for alcoholism. But they do help minimize the chances of a relapse and strengthen your long-term recovery. These three medications help you manage AUD in the following ways:
Disulfiram: This medication is used in treating chronic alcoholism. It is particularly useful for people who have already completed an alcohol detox program or are in the early stage of abstinence.
Naltrexone: Similar to OUD treatment, naltrexone inhibits euphoric effects and sensations of alcohol intoxication. It helps patients with alcohol addiction progressively lower their drinking levels to remain in recovery or avoid relapses.
Acamprosate: Acamprosate is a medication administered after a patient stops drinking alcohol. It works by normalizing alcohol-related changes in the brain and reducing some of the extended physical and emotional discomfort caused by post-acute withdrawal syndrome.
MAT for Mental Health Treatment
Mental health disorders and substance use disorders affect over 7.7 million adults in the U.S. These illnesses are common, recurrent, and often serious but generally go untreated. Mental health disorders involve changes in thinking, mood, and behavior. These disorders can affect how we relate to others and the choices we make in life. The coexistence of both mental health and a substance use disorder is referred to as co-occurring disorder. The treatment of co-occurring disorder involves having to address both substance abuse and mental health concurrently.
If underlying causes of addiction like mental illnesses are not addressed properly, relapses are almost inevitable. To understand the effectiveness of medications in addiction treatment, one must also understand why it’s important to treat mental illnesses effectively. Psychotherapy like cognitive behavioral therapy (CBT) is a common approach to treating mental illnesses like depression and anxiety. But, much like the use of medications in addiction treatment, medications can also be an effective enhancement in mental health treatment. The utilization of MAT therapy in treating both conditions has proven to be an effective combination.
Effectiveness of Medication-Assisted Treatment
MAT has proven to be a useful and beneficial form of treatment for helping patients overcome SUD. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), medication-assisted treatment is considered an evidence-based therapy. Indicating that unlike other conventional treatment methods, this method has been researched and backed by the scientific community to be clinically effective. When MAT is used correctly, it increases the chances of long-term recovery.
Besides reducing the risk of a relapse, MAT programs can also help prevent infectious diseases such as HIV and reduce overdose deaths. Unfortunately, this form of therapy is underutilized, although it shows great promise. It has been estimated that less than 1 million of the 2.5 million Americans diagnosed with OUD in 2012 utilized MAT as part of their treatment program.
Some other benefits of MAT include:
- Improved patient survival
- Increased retention in treatment
- Increased patients’ ability to gain and maintain employment
- Decreased illicit opiate use and other criminal activity among people with SUDs
- Improved birth outcomes among women who have SUDs and are pregnant
Does MAT Substitute One Addiction for Another?
Unfortunately, this is a common misconception about MAT. This evidence-based treatment method relieves psychological cravings and withdrawal symptoms that trigger chemical imbalances in the body. It also maintains a healthy and controlled dose of medication to overcome addictions.
The risk of forming an addiction to the medications utilized during MAT therapy is extremely low.
Who Should You Consult for Medication-Assisted Treatment?
Patients who wish to overcome substance use disorder or mental health disorder must seek counsel through an addiction treatment center or a healthcare provider.
Only a certified OTP can prescribe and dispense methadone used in opioid addiction treatment. A physician who has obtained a waiver from the Drug Enforcement Administration (DEA) after taking specified training in using these drugs can prescribe you Buprenorphine-containing medications, such as Suboxone. Any licensed physician can prescribe you naltrexone. Treatment can take place in a hospital environment, in a primary healthcare physician’s office, or in residential rehabilitation centers.
All in all, MAT is an effective choice of treatment when addressing OUD, AUD, mental health disorder, and co-occurring disorder.