Much of the research that once regarded abstinence-based therapy as the solution to SUD is now shifting in favor of MAT as a more reliable and holistic method for long-term success. However, there are still some professionals who view MAT as a way of perpetuating prescription reliance by substituting one medication for another.
While some people may be deterred by hearing arguments against certain treatments, it’s important to remember that there will be criticism and discussion surrounding interventions of all sorts. This speculation is a crucial part of laying out the facts for everyone who needs to know both sides of treatment before moving forward. Discussion about the pros and cons of MAT complements the comprehensive nature of this treatment by ensuring it meets each person’s needs.
Below, we explore the basics of MAT, the mechanisms that make it an impactful option for individuals with substance use disorders, and each medication that is used to encourage recovery for the various types of addiction.
Outcomes and Goals of MAT
Medication-assisted treatment has been proven to help prevent overdose and relapse in individuals recovering from substance use disorder. This type of treatment is provided on an outpatient basis, so it also can reduce the need for and likelihood of someone entering an inpatient detoxification program or residential treatment facility. MAT has also been strongly correlated with increased compliance to treatment recommendations and boost someone’s chances of getting and maintaining gainful employment opportunities.
While these direct effects are quite significant, the indirect outcomes associated with MAT also play a large part in increasing the quality of life of someone in recovery from addiction. Studies have shown that MAT decreases criminal activity by lowering the cravings that someone experiences. This also protects them from further complications by preventing the potential switch from prescription medications such as opiate painkillers to street drugs like heroin.
By directly limiting someone’s chance of relapse and drug use, MAT also prevents individuals from developing complications associated with SUD, including hepatitis, human immunodeficiency virus (HIV), infections, cirrhosis, and more. Such medications also assist pregnant women with SUD in improving the health of their babies upon delivery. This, therefore, reduces the risk that substance dependence will be passed on to the child and allows them to reach their developmental milestones at the same level as their peers.
Medications Used for MAT
Since MAT is a medication-basedtreatment, each prescription requires approval from the Food and Drug Administration (FDA). Thankfully, there are a variety of medication options that have been approved by the FDA for the treatment of several SUDs. Remember that these medications are not a cure for substance use disorder. They can be an effective way to manage the substance use itself, but not the underlying triggers for substance use.
MAT Options for Alcohol Use Disorder
- Acamprosate, more commonly known by the brand name Campral, is used to ease cravings associated with alcohol use disorder. This medication is chemically similar to the neurotransmitter GABA, which decreases nervous system activity and produces a calming effect on the mind. For this reason, Campral can relieve mental health symptoms (such as anxiety and depression) that may serve as triggers for alcohol intake.
- Disulfiram, also called Antabuse, is another medication to prevent alcohol usage. Antabuse has a different effect on the body in that it blocks a certain enzyme that helps someone properly break down alcohol. As a result, someone taking this medication will experience a range of uncomfortable symptoms whenever they consume alcohol. As with other MAT options, Antabuse is only effective when paired with counseling options, since talk therapy can help someone replace alcohol with a more positive habit.
- Naltrexone (also known as Vivitrol or Revia), is dual-purpose and can be used as a method of MAT for individuals with either opioid use disorder or alcohol use disorder. This medication works by blocking the effects that opioids and alcohol have on the body. It’s a common misconception that naltrexone itself causes individuals to experience feelings of euphoria, but this is not the case. It simply makes it more difficult for someone to feel euphoric as a result of opioids or alcohol.
MAT Options for Opioid Use Disorder
- Buprenorphine is a safe, long-term medication to assist with managing opioid use disorder. This is an ideal way to manage cravings for both types of opioids: prescriptions such as oxycodone and hydrocodone as well as ones that offer quick feelings of euphoria, such as codeine, morphine, and heroin. This drug is more often known by its brand names: Buprenex, Belbuca, and Probuphine.
- Methadone is perhaps one of the most common MAT options and, like buprenorphine, it is a long-lasting way to manage opioid addiction. Methadone is widely available as the brand name Methadose, but it may assume other names depending on where you are located. Methadone is considered a narcotic and a pain reliever, so it may also be used for individuals with chronic pain from an injury or severe illness.
- As we mentioned above, naltrexone (also known as Vivitrol or Revia), is dual-purpose and can be used as a method of MAT for individuals with alcohol use disorder but it’s also effective for people with opioid use disorder. Naltrexone works similar to Antabuse in that it blocks the effects that alcohol has on the body, making it more difficult for someone to get enjoyment from this substance.
Since these medications are meant to serve the purpose of preventing opioid use by reducing cravings and eliminating risk-taking behaviors that lead to illicit drug use, it is not recommended to start or stop using them without consulting your doctor. Be sure to discuss any other medications you are currently taking so your doctor can determine if there will be any negative interactions.
Medication-assisted treatment can make a big difference in the life of someone struggling with substance use disorder. Some medications can even be helpful for someone with more than one type of addiction, called poly-substance use disorder. If you have been trying to abstain from substances or engaging in talk therapy with little to no effects, it may be time to try MAT. The next step beyond expressing interest is discussing this (and other options) with your doctor. It’s important to be honest with your providers regarding the types and frequency of your substance use along with your past treatment history, periods of compliance, and other prescriptions medications you might be on. This will help them best advise you regarding suitable treatment options.