Medication-Assisted Treatment

What Is Medication-Assisted Treatment?

Sometimes, the use of medications—or Medication-Assisted Treatment (MAT) can be beneficial to patients during the recovery process for alcohol or drug addiction.

By using medication combined with behavioral therapy, healthcare providers can ease the side effects of withdrawals and help the patient remain sober throughout their recovery journey.

The specific medications prescribed during MAT are used only for specific addictions. MAT may not be suitable for all cases of substance use disorder (SUD).

In some cases, your prescribing physician may recommend a complementary medication during your recovery—such as antidepressants—to manage symptoms from a co-occurring condition.

MAT is only FDA-approved for treating the following substance use disorders:

• Alcohol Use Disorder (AUD)
• Opioid Use Disorder (OUD)—including addiction to prescription opioids (codeine, fentanyl) and illicit opioids (heroin)

Whether or not you need medication-assisted treatment is something that can be determined by your primary care doctor or similar healthcare provider specializing in addiction medicine.

How Effective Is Medication-Assisted Treatment?

Evidence shows that medication-assisted treatment is clinically effective. Not only do these medications help to prevent relapse and promote patient overall recovery, but MAT has also been shown to reduce cases of patients contracting HIV and other bloodborne illnesses.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), medication-assisted treatment has been shown to be effective in the following categories for patients:

• Improving survival
• Improving patient retention during treatment
• Reducing illegal drug use
• Reducing criminal activity
• Improving birth outcomes
• Improving employment rates (acquiring jobs and remaining employed)

Additionally, the Department of Health and Human Services (HHS) reports,

“Without MAT, the chances of relapse for a person who suffers from [opioid use disorder (OUD)] are significant; studies have shown that outcomes for people with OUD are much better with MAT.”

Common MAT Medications

The U.S. Food and Drug Administration (FDA) has approved the use of certain medications in the treatment of individuals with certain substance use disorders. These medications can relieve symptoms of withdrawal and help to prevent cravings for the original addictive substance.

The following FDA-approved medications may be used for treating opioid use disorder:

• Buprenorphine (Suboxone®, Zubsolv®, Sublocade®)
• Methadone (Methadose®, Dolophine®)
• Naltrexone (Vivitrol®, Revia®)

Additionally, these FDA-approved medications can be used for treating alcohol use disorder:

• Acamprosate (Campral®)
• Disulfiram (Antabuse®)
• Naltrexone (Vivitrol®, Revia®)

Acamprosate

Acamprosate, a common medication in treating alcohol use disorder, works by helping to restore balance in the brain. It helps recovering alcoholics by reducing (or even eliminating) cravings for alcohol.

However, acamprosate does NOT impact any alcohol withdrawal symptoms outside of cravings, so additional medications or support are likely needed alongside an acamprosate prescription.

One factor that makes acamprosate unique in treating AUD is that the liver does not metabolize it. That means recovering alcoholics with liver disease can still safely take acamprosate.

However, this also means recovering patients who relapse (by returning to alcohol use) will NOT experience any adverse side effects—so acamprosate doesn’t necessarily work as a relapse deterrent outside of reducing cravings.

Buprenorphine

Buprenorphine is often used for the treatment of opioid dependence. It works by targeting the same brain receptors as opiates but to a much weaker degree.

By targeting the same part of the brain, this partial opioid agonist helps patients by decreasing cravings and withdrawal symptoms.

Buprenorphine treatment comes in a few different forms, such as extended-release tablets. One of the more common buprenorphine prescriptions is a formulation that includes the drug naloxone (Suboxone®), a long-acting medication.

Prescriptions for buprenorphine as part of a treatment plan for battling opioid addiction are not uncommon.

Many medical professionals assert that buprenorphine is “the gold standard” in opioid treatment programs (OTP) due to how effective it can be in helping patients avoid relapse and opioid overdose.

Disulfiram

Disulfiram is an FDA-approved medication used for treating alcohol use disorder. Disulfiram works best as a deterrent to keep recovering alcoholics from relapsing.

If a patient on disulfiram drinks alcohol, they risk becoming violently ill (vomiting). By creating that fast-acting physical consequence, many individuals in AUD recovery find themselves more able to resist temptation and focus on their overall well-being.

Methadone

Methadone is a full opioid agonist that is used to treat opioid use disorder. Methadone is much stronger than a partial opioid agonist like Buprenorphine, and doses can be changed to suit the individual’s needs.

Methadone reduces cravings for opiates and dulls any effects of opiates if some were to be taken. Methadone is taken daily under medical supervision, such as a methadone clinic; it is not available for take-home use for patients with opioid use disorder.

Methadone comes in powder, liquid, and diskette form. When used as directed, methadone is overall safe. However, methadone can be habit-forming. It is becoming less common in MAT due to its potential for abuse or dependency.

Naltrexone

Naltrexone is a medication that can be used for the treatment of alcohol use disorder and treatment of opioid use disorder.

Naltrexone is not an opioid, nor is it addictive. It works by binding to certain brain receptors, causing the brain not to receive the euphoric effects of either opiates or alcohol.

Prescription naltrexone medication is available in daily pill format for alcohol use disorder but also has a long-acting, extended-release option that can be administered monthly by a physician (Vivitrol) to treat either alcohol use disorder or opioid use disorder.

Medication-Assisted Treatment: Myths vs. Facts

There are still some common misconceptions about medication-assisted treatment. Some people are concerned about the effectiveness of MAT, while others question the overall safety of this type of treatment option.

However, many concerns about MAT are the result of misinformation. Here are some common myths about MAT and the facts behind each issue.

MYTH: MAT increases overdose risk.

The opposite of this is true: MAT prevents overdoses from happening. Because MAT medications both block the effects of drugs and alcohol and reduce cravings, patients are far less likely to relapse and overdose.

MYTH: MAT is just trading one addiction for another.

The medications prescribed for MAT do not impact the body in the same way as opioids or alcohol. MAT prescriptions work by eliminating the positive effects associated with alcohol or opioids and by reducing cravings for those substances.

MYTH: MAT isn’t meant for long-term use.

MAT can be an important part of maintenance when it comes to addiction treatment. The average medication-assisted treatment plan runs from 1-2 years.

MYTH: MAT is only for extreme addiction.

MAT can be beneficial for any level of addiction, and doses can be tailored to fit the needs of the individual patient.

MYTH: MAT makes recovery more difficult.

MAT can improve the patient’s quality of life and ability to function daily, which greatly supports their recovery.

MAT Treatment and Behavioral Therapy

MAT is not designed to be used on its own. Evidence-based treatment like psychotherapy is usually a requirement when MAT is part of someone’s treatment plan.

Behavioral health is a key focus alongside medication-assisted treatment, and counseling or other therapies are usually part of addiction treatment that includes medication.

During therapy, the patient will work on identifying negative thought patterns and triggers that contributed to their substance abuse and then aim to create new habits and patterns of thinking.

While MAT will increase the patient’s quality of life and help them avoid relapsing, MAT works best with a “whole patient” approach.

Find the MAT That Works Best for Your Recovery

Considering medication-assisted treatment as part of your recovery plan?

Find a center near you using the Substance Abuse and Mental Health Services Administration (SAMHSA) online treatment locator or call their free, confidential helpline at 1-800-662-4357 to get a referral for addiction treatment services like MAT.