While people who struggle with several types of substances benefit from different approaches to MAT, opioid-specific programs are expanding to slow the opioid addiction epidemic. Some other substances also benefit from MAT.
Medical researchers are trying to develop new treatments to manage withdrawal from a wider range of substances.
Medication-assisted treatment is a science-based holistic treatment to overcome addiction to substances like opioids, tobacco, or alcohol. This “whole-patient” approach to treatment combines prescription medications with behavioral counseling.
First, a doctor prescribes medications that relieve withdrawal symptoms, so the individual’s body is physically stabilized, allowing them to slowly detox from the substance until they are no longer dependent on it. Some medications lessen the severity of withdrawal symptoms, whereas others nearly eliminate them altogether.
Once the person is physically stable, they can enter group or individual counseling. In therapy, they can learn how to manage cravings, stress, and triggers to abuse drugs as well as how to develop a daily routine that supports abstinence.
Most approaches to treating drug and alcohol abuse involve medical detox first. Then, when the individual is no longer physically dependent on the substance, they can enter a rehabilitation program for behavioral therapy and develop an aftercare plan once they complete rehab.
But many substances like opioid drugs can lead to such extensive physical dependence that slowly tapering the body off the substance works better. Working with therapists during this process creates a support structure to understand previous behaviors and change them.
Under a 2018 federal law, people entering medication-assisted treatment programs must receive behavioral counseling in addition to medication management. Further required services include vocational, educational, and other assessment services to help the transition into abstinence in daily life.
Medication-assisted treatment has been shown to:
The U.S. Food and Drug Administration (FDA) has approved several different medications to manage withdrawal symptoms and achieve physical stability. Research shows that, with the proper dose of a medication, there are no adverse effects on a person’s intelligence, employability, physical functioning, and mental capacity when they use medications to manage substance use disorders.
Opioid use disorder (OUD) is the biggest focus for MAT approaches, but other substances benefit from medication management. Addictions to these substances are most commonly treated with MAT:
The leading medications used in opioid medication-assisted treatment are:
The FDA and research groups are investigating several medications that may treat other addictive disorders that currently have no form of MAT associated with them. For example, addiction to cocaine can involve severe withdrawal symptoms and a high risk of relapse. Finding MAT approaches for cocaine addiction could help many people.
Drugs being investigated as potential MAT prescriptions include:
People who struggle with addiction are more likely to also struggle with mental illness. The comorbidity of these conditions is high enough that it is often difficult to tell whether a pre-existing mental illness, like depression, anxiety, or bipolar disorder, leads to substance abuse, or whether abusing drugs or alcohol triggers a mental illness. Regardless, many addiction treatment programs now screen for mental health disorders, so that both addiction and mental health issues can be addressed at the same time.
To that end, one of the most potentially important forms of MAT is prescription antidepressants. Serotonin specific reuptake inhibitors (SSRIs) like citalopram and fluoxetine can manage underlying stress from a mental health condition by stabilizing serotonin and dopamine management in the brain. This, in turn, can reduce cravings and reduce reactive, negative behaviors.
SSRIs may not be appropriate for everyone. Taking these does not decrease the usefulness of other forms of medication-assisted treatment like buprenorphine or naltrexone.
Thanks to changes in federal law, access to MAT for opioid use disorder is improving, and other medications are being investigated to alleviate withdrawal symptoms for other substances like cocaine or methamphetamines.
The combination of tapering off physical dependence with behavioral therapy helps thousands of people in the United States every year. With ongoing research and continued advancements in the field, medication-assisted treatment will be able to help a wider group of people in the future.