Author: Kerry Nenn

Medication Assisted Treatment (MAT)

Angela has tried everything. From counseling to self-control, to rehab – Angela has tried again and again to stop using opioids. After multiple relapses, she is discouraged and wonders if there is hope for recovery. Then she hears about something she hasn’t tried: medication-assisted treatment (MAT). Angela’s friend swears it worked wonders for her. So, Angela decides to look into this treatment option. Maybe it’s the solution she’s been hoping for…

What is MAT?

Medication-assisted treatment (MAT) is the use of medications, combined with counseling and behavioral therapies, to provide a whole-patient approach to the treatment of substance use disorders.¹ Medications treat the physical side of addiction, while counseling addresses the emotional and mental aspects. 

The medications prescribed for MAT are approved by the Food and Drug Administration (FDA). Clinical staff prescribe the medications and monitor patient progress, tailoring the MAT to meet individual needs. This method of treatment can help some individuals achieve and maintain recovery.

Angela thinks medication assistance might be the piece that was missing in her previous attempts to quit opioids. This might be the extra support she needs to stay sober for good.

What addictions/substances is MAT used for?

The FDA has approved medications for the treatment of opioid use disorders (OUD) and alcohol use disorders (AUD). Treatment providers may use medication-assisted treatment to address addiction to alcohol, heroin, codeine, morphine, oxycodone, or hydrocodone.²

Angela’s addiction started with the misuse of oxycodone, and now she uses heroin. She is excited to learn that MAT may work for her specific opioid use disorder. 

What drugs are used in MAT?

Angela discovers there are multiple options for medication-assisted treatment. She discusses possible medications with her doctor and learns about several drugs that are approved for substance abuse treatment.

For alcohol use disorder, acamprosate, disulfiram, and naltrexone are the most commonly prescribed drugs. Buprenorphine, methadone, and naltrexone are the most commonly prescribed drugs for the treatment of opioid use disorder.¹

• Acamprosate: This medication reduces the desire to drink alcohol by restoring the natural balance of chemicals in the brain. For the medication to be effective, individuals must stop drinking before they start taking this drug.³
• Buprenorphine: This drug – an opioid partial agonist – reduces cravings for opioids and alleviates withdrawal symptoms. It does so by activating the same receptors as opioids but in a different way, so it doesn’t provide a “high.”⁵
• Disulfiram: This drug prevents the body from processing alcohol properly, so the person taking it has a negative physical reaction if they drink alcohol. They may experience vomiting, headache, sweating, chest pain, weakness, or other symptoms.⁴
  
• Methadone: This long-acting full opioid agonist blocks or reduces the effects of opioids while also reducing cravings. Methadone is available in liquid, powder, and diskette formats.6
• Naltrexone: This medication reduces cravings for alcohol and opioids. It works by blocking the sedative and euphoric effects of these substances.⁷

MAT Timeline: How long does MAT last?

Angela’s next question for her doctor is “how long?” How long will she need to take the medication? She learns that the answer is “it depends.”

For some people, MAT may last one to three months. For others, treatment may extend for a year or more. Doctors consider several important factors to determine how long someone should stay on medication-assisted treatment:

• The severity of the addiction (the degree of physical and psychological dependence)
• Which drug is being prescribed
• The medication dosage
• How the person reacts to the medication
• The person’s support system

The first consideration is the most important. Individuals who have more severe or long-term addictions typically need more time on MAT for it to be effective. 

To stop MAT, doctors look for signs of recovery:

• No use of the substance for an extended period of time
• Cravings are significantly diminished
• Supports are in place to help sustain recovery

Is Medication Assisted Treatment (MAT) effective and safe?

The drugs approved by the FDA for medication-assisted treatment have been demonstrated to be safe and effective when used in combination with counseling and psychosocial support.8 This method is considered the “gold standard” of treatment for opioid use disorder.9

Clinical studies have shown that MAT can:¹

• Increase retention in treatment
• Reduce the risk of relapse
• Improve patient survival
• Decrease illicit opioid use and other criminal activity among individuals with substance use disorders
• Improve employability and job retention
• Improve birth outcomes among pregnant women who have substance use disorders

Specifically, MAT reduces the death rate among those living with addiction by 50% or more,10 and up to 90% of patients who use medication-assisted treatment maintain sobriety at the 2-year mark.¹⁰

After learning about the potential benefits of medication-assisted treatment, Angela works with her doctor to develop a treatment plan that includes MAT. She is hopeful that her new medication, combined with ongoing counseling and a good support system, will help her make the changes she wasn’t able to in the past. She is ready to start on this new path to recovery.

If you or someone you love is experiencing a substance use disorder, help is available. Call 800-934-1582(Who Answers?) today to learn about your treatment options.

Sources:

1. Medications for substance use disorders. (n.d.). SAMHSA. Retrieved January 17, 2024, from https://www.samhsa.gov/medications-substance-use-disorders
2. Medications, counseling, and related conditions. (n.d.). SAMHSA. Retrieved January 17, 2024, from https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions
3. Acamprosate oral: Uses, side effects, interactions, pictures, warnings & dosing. (n.d.). WebMD. Retrieved January 17, 2024, from https://www.webmd.com/drugs/2/drug-91488/acamprosate-oral/details
4. Disulfiram oral: Uses, side effects, interactions, pictures, warnings & dosing. (n.d.). WebMD. Retrieved January 17, 2024, from https://www.webmd.com/drugs/2/drug-1446/disulfiram-oral/details
5. Buprenorphine for opioid use disorder. (n.d.). WebMD. Retrieved January 17, 2024, from https://www.webmd.com/mental-health/addiction/opioid-use-disorder-buprenorphine
6. Methadone. (n.d.). SAMHSA. Retrieved January 17, 2024, from https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions/methadone
7. Naltrexone. (n.d.). SAMHSA. Retrieved January 17, 2024, from https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions/naltrexone
8. Center for Drug Evaluation & Research. (n.d.). Information about medication-assisted treatment (MAT). U.S. Food and Drug Administration. Retrieved January 17, 2024, from https://www.fda.gov/drugs/information-drug-class/information-about-medication-assisted-treatment-mat
9. Mittal, M. L., Vashishtha, D., Sun, S., Jain, S., Cuevas-Mota, J., Garfein, R., Strathdee, S. A., & Werb, D. (2017). History of medication-assisted treatment and its association with initiating others into injection drug use in San Diego, CA. Substance Abuse Treatment, Prevention, and Policy, 12(1), 42. https://doi.org/10.1186/s13011-017-0126-1
10. 10 Things You Need to Know About Medication-Assisted Treatment. (n.d.). Https://Dss.Sd.Gov/Formsandpubs/Docs/BH/BHAO10_MAT_Brochure.Pdf; South Dakota Departments of Health and Social Services. https://dss.sd.gov/formsandpubs/docs/BH/BHAO10_MAT_Brochure.pdf