Medication-Assisted Treatment (MAT)

Medication assisted treatment (MAT) uses FDA-approved medications to treat alcohol addiction and opioid use disorders. Medication assisted treatment can:

Reduce opioid cravings
Lower your risk of relapsing
Support long-term recovery

What Is Medication Assisted Treatment?

MAT is a way to treat alcohol and opioid use disorders using medication. People sometimes take medications to help them detox from drugs. It’s true that medication assisted treatment can be used in medical detox settings, but it can also be effective in inpatient or outpatient addiction treatment.

How Does Medication Assisted Treatment Work?

There are two reasons MATs are effective in treating opioid use disorders:

They bind to opioid receptors in the brain and activate them. This is similar to how opioids work on the brain but to a lesser extent.
They completely block the receptors that cause pleasant feelings. This prevents you from feeling euphoria when you take drugs and may motivate you to stay away from them.

Medication assisted treatment 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 alcohol or opioid treatments, like counseling and behavioral therapy.

How MAT Is Used in Opioid and Alcohol Treatment Programs

Medication assisted treatment is one tool that can be used in an overall treatment program for opioid addiction or alcohol addiction. MAT can help reduce cravings and lower the risk of relapse, and it can be an effective tool for sustained long-term recovery. Medication assisted therapy is not a cure for addiction, and it is most effective when combined with counseling and behavioral therapy. This way, your substance use and mental health are both considered in treatment.

There are many different types of treatment approaches that can be combined with medication assisted treatment. Some of the most common ones include cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), and contingency management. These treatments can help you understand the thoughts and emotions that may trigger drug use, and they can teach you new skills to cope with stress and temptation. Behavioral health treatments can also help you build a support network to help you stay sober.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy is a type of talk therapy that helps people understand and change the thoughts and behaviors that contribute to their opioid addiction. It can be used alone or in combination with medication assisted treatment.

CBT can help you learn how to:

Manage your emotions
Deal with stressful situations
Resist the urge to use opioids
Stay in treatment
Prevent relapse

CBT is usually provided by a licensed therapist, in individual or group sessions. It typically lasts for 12 weeks or more, although some people may need shorter or longer courses of treatment.

Dialectical Behavior Therapy (DBT)

Dialectical behavior therapy is a type of cognitive behavioral therapy that has been shown to be effective in treating a range of mental health conditions, including addiction. DBT was originally developed to treat people with borderline personality disorder, but it has been found helpful for other conditions, including opioid dependence.

DBT helps you change the way you think and behave, so you can manage difficult emotions and addictive behaviors. It’s a highly structured treatment that involves weekly individual counseling sessions and group skills training sessions.

DBT has been shown to effectively treat opioid addiction. It can reduce opioid use and improve other outcomes, such as mental health symptoms and quality of life.

Contingency Management

Contingency management is a type of behavioral therapy often used to treat opioid addiction. It is effective because it uses positive reinforcement to encourage you to stay clean. You receive rewards, such as money or vouchers, for staying abstinent from opioids. This can motivate you to continue treatment and avoid relapse.

Psychosocial Services

Aside from medication, there are several psychosocial services that can be used in conjunction with medication assisted treatment. These services can include:

Individual or group counseling
12-step programs
Vocational rehabilitation
Housing assistance

They vary depending on your needs and can be tailored to your specific situation.

Coordinated Treatment

When using medication assisted treatment for opioid use disorders or other substance abuse, it’s important to coordinate and integrate the treatment with other medical or psychological needs you have. This helps ensure that all your needs are addressed and you’re getting the most comprehensive care possible.

One approach is to have a case manager or treatment coordinator who is responsible for coordinating all of your care. This case manager works with your doctors and therapists to make sure everyone is on the same page.

Another approach is to have a team of professionals who work together to provide coordinated care. The team could include:

Addiction medicine doctors
Nurses
Case managers
Therapists
Social workers
And others

This approach can be especially useful for people who have complex needs.

No matter what approach is used, it’s important that everyone involved in your care is aware of all of your opioid addiction treatments and services. This will ensure you get the most benefit from all the care you’re receiving.

When Do You Start Medication Assisted Treatment?

Medication assisted treatment may be used throughout treatment. Some people start MAT at a safe point in medical detox, while others find a need for it further into treatment. Depending on clinical needs, medication assisted treatment may be used in any of these levels of care:

Medical Detox

You receive around-the-clock care from a medical team. They use medication for the treatment of drug or alcohol withdrawal symptoms and keep you safe and as comfortable as possible while you eliminate alcohol, opioids, or other drugs from your system.

Residential Treatment

You live at a drug rehab center like Footprints to Recovery in apartment-like or dorm-style residences. You attend addiction treatment during the day and participate in recovery activities like 12-step meetings or sober socializing opportunities in the evenings.

Partial Hospitalization Program (PHP)

You attend programming at the treatment facility during the day but live at home or in a sober living residence. Day programming is similar in length and offerings as inpatient treatment programs.

Intensive Outpatient Program (IOP)

You start re-integrating back into everyday life by working, going to school, or returning to family responsibilities while attending alcohol and drug abuse treatment for around 12 to 15 hours a week.

Outpatient Program

You are fully integrated back into life while attending one to three hours of programming each week at an addiction treatment center to maintain regular support in early sobriety.

Addictions That MATs Treat

People addicted to opioids, alcohol, and nicotine may benefit from medication assisted treatment.

Here are some of the medication assisted treatments for those conditions:

Alcohol Use Disorders

Vivitrol or Revia(naltrexone)
Campral (acamprosate)
Antabuse (disulfiram)

Opioid Use Disorders

Opioids that can be treated with MAT include heroin and several prescription opioids:

Heroin
Morphine
Codeine
Hydromorphone (Dilaudid)
Opium
Hydrocodone
Oxycodone
Fentanyl

Medication assisted treatments used to treat these opioid addictions include:

Methadone, Methadose, or Dolophine
Buprenex, Suboxone, Subutex, Zubsolv, Sublocade, or Butrans (buprenorphine)
Vivitrol, Revia, or Depade (naltrexone)

Tobacco Use Disorder

MATs used to treat nicotine addictions include:

Nicotine-replacement therapies (NRTs)
Wellbutrin or Zyban (bupropion)
Chantix or Tyrvaya (varenicline)

Medications for Opioid Use Disorders

Medications used in treating substance abuse work in similar but different ways.

Methadone for Heroin Use

Methadone is a medication that is approved by the U.S. Food and Drug Administration (FDA) to treat people who are addicted to heroin. It helps with cravings for opioids. People usually visit a methadone clinic each day to receive their doses. Methadone is an opioid itself. Some doctors prescribe it to people who have moderate to severe pain, but it can also be abused, which is why you must receive methadone at an approved clinic. You may be allowed to take methadone at home but only after you have proved 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 a drug that helps reduce cravings and withdrawal symptoms. It is considered a partial opioid agonist, which means it has weaker effects than full opioid agonists (like heroin).

Buprenorphine comes in several forms, including:

Dissolvable tablets placed under the tongue (Subutux)
Dissolvable film strips placed under the tongue (Suboxone)
A long-acting injection (Sublocade)

Naltrexone (Vivitrol or Revia) for Opioid or Alcohol Abuse

Naltrexone (Vivitrol or Revia) can help people with opioid or alcohol use disorders. Naltrexone is not an opioid, and it is not addictive. It blocks the pleasurable effects of opioids and alcohol, and it also helps suppress cravings.

Naltrexone is available as a pill or an extended-release injection.

Disulfiram (Antabuse) for Alcohol Use

Disulfiram (Antabuse) is a medicine for the treatment of alcohol abuse. It makes you feel very sick when you drink alcohol. This is because it causes reactions like:

Nausea
Stomachaches
Headaches
Fatigue

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

Disulfiram comes in tablet form.

Acamprosate (Campral) for Alcohol Use

Acamprosate (Campral) is a medication that can help people recover from an alcohol use disorder. It does not prevent withdrawal, but it can relieve some uncomfortable alcohol withdrawal symptoms. Campral also helps reduce cravings.

It comes in tablet form and is usually taken three times per day.

Bupropion (Wellbutrin or Zyban) for Tobacco Use

Bupropion (Wellbutrin or Zyban) is a medication originally developed to treat depression, but it can also help people stop smoking. This is because bupropion stimulates norepinephrine and dopamine in the brain.

Bupropion comes as an immediate-release or extended-release tablet.

Varenicline (Chantix or Tyrvaya) for Tobacco Use

Varenicline (Chantix or Tyrvaya) helps reduce nicotine cravings. It acts on the same receptors as nicotine does but to a lesser degree. You can take it once or twice a day, and your doctor might prescribe you varenicline one week before you plan 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 medication assisted treatment for addiction, 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.

Methadone and buprenorphine can be abused if you take more than the prescribed amount. This is why it’s important to take all medication as directed by a medical professional. If you are worried about misuse, talk to your doctor about different options for treatment of opioid abuse. Your treatment team will help you find the best option for your needs.

Pros and Cons of Medication Assisted Treatment

Everyone’s recovery journey is different. That is why it’s important to think about the pros and cons of medication assisted treatment before you start. Remember, you are not alone in making this decision. Trained professionals will help you choose the best option for your care.

The pros of medication assisted treatment both individually and in communities include:

Decreased use of opioids
Fewer opioid overdose deaths
Relief from difficult withdrawal symptoms
Relief for those who have struggled with chronic opioid relapse
Decrease in the number of people getting sick from infectious diseases
More people following the treatment programs they are given
Support for pregnant mothers struggling with opioid addiction

The cons of medication assisted treatment include:

You need to take methadone every day (if prescribed).
Finding a MAT program can be difficult.
Drug dealers may target people in medication assisted treatment programs because they know those people are more likely to abuse opioids.
Depending on your health insurance, the cost of this type of medication can vary.
Some people in recovery do not support using medication to treat addiction (MAT), which could lead to potential stigmatization.

Is Medication Assisted Treatment Expensive?

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

Methadone treatment costs about $126 per week ($6,552 per year).
Buprenorphine treatment costs about $115 per week ($5980 per year).
Naltrexone treatment costs about $1,176 per month ($14,112 per year).

The prices of other drugs vary more. That’s because the prices of prescription drugs depend on location and health insurance.

It is important to compare the costs of medication assisted treatment with the costs of not treating your substance use disorder. This includes the costs of:

Drugs and related paraphernalia
Potential legal expenses
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.

Do I Need Medication Assisted Treatment?

Talk with your physician or addiction treatment team. They will help you walk through the risks and benefits of taking medication to treat your addiction. You don’t need to commit to one approach forever. Many people use medication when they first enter alcohol or opioid treatment, but then they may no longer need it later on.

At Footprints to Recovery we treat clients struggling with substance abuse and mental health disorders. We prescribe medication assisted treatment as clinically appropriate and customize our treatment to best meet your specific needs. We treat the root causes of substance use disorders (SUDs) like co-occurring disorders and trauma so you can address the reasons behind your addiction.

We’re here for you, and we’re excited to help you on your journey toward recovery. Contact us today to get started.

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