Medication-Assisted Treatment (MAT)

Medication-assisted treatment (MAT) uses FDA-approved medications to treat opioid use disorders. MAT can be an effective at:

  • Reducing cravings
  • Lowering your risk of relapsing
  • Sustaining long-term recovery

What Is MAT, and How Does It Work?

MAT is an umbrella term for using specified medication to treat opioid and alcohol use disorders and sometimes tobacco. You may have heard of people taking medications to help them detox from drugs. It’s true that MAT is used in medical detox settings, but it can be effective in all levels of care, including outpatient treatment.

Depending on the specific medication, MAT works in one of two ways:

  1. By binding to opioid receptors in the brain and activating them – This is similar to the way that opioids work on the brain, but MAT medications do it to a lesser extent.
  2. By completely blocking the receptors that cause pleasant feelings – This prevents you from feeling euphoria when you take drugs, which may motivate you to stay away from them.

MAT isn’t a cure for addiction. It’s a tool that can jumpstart and support your recovery. MAT is usually most effective when it’s combined with other treatments, like counseling and behavioral therapy.

The Addictive Drugs That MAT Can Help

empty wine glasses on table with people drinking around it

Alcohol

Naltrexone, acamprosate, and disulfiram help treat alcohol use disorders.

Opioids

Opioids that can be treated with MAT include:

  • Heroin
  • Morphine
  • Codeine
  • Hydromorophone (Dilaudid)
  • Opium
  • Hydrocodone
  • Oxycodone
  • Fentanyl

Methadone, buprenorphine, and naltrexone help treat opioid use disorders.

Tobacco

Nicotine-replacement therapies can help with tobacco use.

Medications Used in MAT

Methadone for Heroin Use

Methadone is the oldest FDA-approved medication for treating heroin addiction. It helps with opioid cravings. Clients usually visit a methadone clinic each day to receive their doses.

Methadone itself is an opioid. Doctors sometimes prescribe it to treat moderate to severe pain. But it can also be abused. That’s why patients must receive methadone at an approved clinic. You may be allowed to take methadone at home but only after you’ve proven yourself to be stable over a period of time.

Methadone is available in pill, liquid, or wafer-form. It’s taken once a day.

Buprenorphine for Several Substances

Buprenorphine is considered a partial opioid agonist. It can reduce cravings and ease withdrawal symptoms. You may feel some opioid-related effects, even if you take it as part of MAT. But compared to full opioid agonists (like heroin), the effects are much weaker.

Buprenorphine comes in several forms, including:

  • Dissolvable tablets placed under the tongue (Subutux)
  • Dissolvable film strips placed under the tongue (Suboxone)
  • An extended release-injection (Sublocade)

Naltrexone for Opioid or Alcohol Use

Naltrexone can help treat opioid and alcohol use disorder. It is not an opioid, and it’s not addictive. Instead, naltrexone blocks pleasurable opioid or alcohol effects. It also helps suppress cravings. Naltrexone is available in pill form and as an extended-release injection.

Disulfiram (Antabuse) for Alcohol Use

Disulfiram treats alcohol use disorder. It works by triggering an unpleasant reaction when drinking alcohol. These reactions may include:

  • Nausea
  • Stomachaches
  • Headaches

When you experience these effects after drinking alcohol, you may be less likely to drink.

Disulfiram comes in a tablet form.

Acamprosate for Alcohol Use

Acamprosate also treats people recovering from alcohol use disorder. It doesn’t prevent withdrawal, but it can relieve some of the uncomfortable symptoms. It also helps reduce cravings. Acamprosate comes in tablet form. It’s usually taken three times per day.

Bupropion for Tobacco Use

Bupropion was originally developed as an antidepressant, but it can also help people stop smoking. It works by stimulating norepinephrine and dopamine in the brain. Bupropion comes in immediate-release and extended-release tablets.

Varenicline for Tobacco Use

Varenicline (sold under Chantix) helps reduce nicotine cravings. It acts on the same receptors as nicotine does, but to a lesser degree. It comes in a tablet form you can take once or twice a day. Your doctor might prescribe you varenicline one week before the day you intend to stop smoking. Most people take this medication for 12 weeks.

Will I Get Addicted to the Drugs Used in MAT?

There are benefits and risks associated with all forms of recovery treatment, and there isn’t one method that works for everyone. It’s important to find the treatment that suits your situation or that of your loved one.

It is possible to abuse methadone and buprenorphine. The abuse can occur if you take more than prescribed, which is why it’s essential to take all medication as directed by a medical professional.       If you’re concerned about misuse, talk to your doctor about alternative options. Your treatment team will help you evaluate the appropriate method for your recovery needs.

Pros and Cons of MAT

two women sit across from each other at table in front of window

There isn’t a “right” way to recover from addiction. Instead, it’s about finding a method that works for you. Therefore, it’s important to outweigh the pros and cons before engaging in MAT. You’re not alone in making these decisions. Trained professionals will help you evaluate the best choice for your care.

The pros include:

  • Reduced rates of opioid use
  • Fewer overdose deaths related to opioids
  • Immense relief for difficult withdrawal symptoms
  • Relief for people struggling with chronic opioid relapse
  • Decreased rates of infectious disease transmission
  • Increased compliance in treatment programs
  • Support for pregnant mothers struggling with opioid addiction

The cons include:

  • Potential for misuse and abuse (with methadone and buprenorphine) – This risk is significantly lower when methadone and buprenorphine are prescribed as part of formal treatment through an addiction treatment center.
  • Need daily dosing (with methadone)
  • Can be hard to find MAT programs
  • Drug dealers potentially targeting people in MAT programs because they know they are prone to abusing opioids
  • Possible cost of the medication, depending on health insurance
  • Potential stigmatization because some people in recovery do not support MAT

Is MAT Expensive?

The cost of MAT varies. According to the U.S Department of Defense, cost estimates break down like this:

  • Methadone costs about $126 per week ($6,552 per year).
  • Buprenorphine costs about $115 per week ($5980 per year).
  • Naltrexone costs about $1,176.50 per month ($14,112 per year).

The prices of other drugs are more variable. That’s because all prescription costs vary based on location and health insurance.

Still, it’s important to compare the costs of MAT with what it costs not to treat your substance use disorder, including:

  • The cost of drugs and related paraphernalia
  • Potential legal expenses
  • Costs associated with missing work
  • Medical fees and hospital bills (in the event of an overdose or other medical issue)

Think of MAT—if you need it—as an investment in yourself and your future. You need to be well before you can be your best self.

How to Know If You Need MAT

Talk with your treatment team. They will help you evaluate the risks and benefits associated with MAT.  It’s essential that you consult with professionals instead of making a decision impulsively.

Remember that you don’t need to commit to one approach forever. Many people use MAT when they first enter treatment. Over time, they may no longer need the medication to support their recovery.

At Footprints to Recovery, we support clients struggling with drug and alcohol use disorders. We customize our treatment to best meet your individual needs. We’re here for you, and we’re excited to help you on your journey towards recovery. Contact us today to get started.

References

  1. https://psychiatry.uams.edu/clinical-care/cast-2/what-is-methadone/
  2. https://www.naabt.org/faq_answers.cfm?ID=2#:~:text=Buprenorphine%20
  3. https://medlineplus.gov/druginfo/meds/a682602.html
  4. https://www.drugabuse.gov/publications/research-reports/tobacco-nicotine-e-cigarettes/what-are-treatments-tobacco-dependence
  5. https://medlineplus.gov/druginfo/meds/a606024.html
  6. https://www.drugabuse.gov/publications/research-reports/medications-to-treat-opioid-addiction/how-much-does-opioid-treatment-cost

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