Medication assisted treatment or MAT is a controversial topic, with even the Secretary of Health and Human Services sharing mixed opinions about it. But, if you’re looking into opioid treatment, MAT programs are likely to be recommended, not just by rehabilitation centers but also by doctors, and government rehabilitation programs. With mixed opinions and mixed information online, you might be wondering, is medication assisted treatment right for you?
The truth is that it’s difficult to say if medication assisted treatment is the best choice for you. You will have to go to a qualified doctor, specialist in addiction medication, or a combination of the two to get an accurate diagnosis and prescription. However, you can learn about MAT, situations where it’s often used, and when it is right for you so that you can make your own decision when you do see a specialist.
What is MAT?
Medication assisted treatment is any program that uses an opioid, typically in combination with another partial or full opioid agonist, to treat opioid addiction. Medication-assisted treatment technically is currently only available for opioid addiction, as there are no FDA-approved drugs to treat addictions to amphetamines, cocaine, marijuana, or alcohol (although drugs such as benzodiazepines are frequently used in treatment to relieve symptoms from other addictions).
Medication-assisted programs typically involve a multi-faceted approach:
Medication – Medication such as Buprenorphine, Naloxone, Suboxone, Methadone, Naltrexone, Disulfiram, Acamprosate and Probuphine. Of these, Suboxone is the most common, and is composed of a mix of buprenorphine, an opioid, and Naloxone, an opioid agonist, allowing it to treat addiction symptoms with less potential for abuse.
Evidence-Based Behavioral Therapy – You will receive evidence-based addiction treatment such as cognitive behavioral therapy while in a MAT program. This typically involves working with a therapist, recognizing harmful behavior contributing to addiction, and learning new thought and behavior patterns to combat addiction and cravings.
Education – Every MAT rehabilitation program works to educate individuals regarding addiction, the treatment they are taking, and its long-term effects. This is part of holistic treatment and cannot be skipped.
Relapse Prevention – Every MAT treatment program includes long-term follow-up, typically long-term medication, and relapse prevention counseling and education. This will typically take several forms, such as access to long-term counseling, attendance at self-help groups like AA, NA, or SMART recovery, and follow-up therapy.
This holistic approach to treatment works to ensure that individuals aren’t suffering from cravings, are clear-headed and able to concentrate and learn when going into therapy, and that they have long-term support throughout the process. By the time you are weaned off of your prescription medication, you’ll have the tools to live happily without drugs, because you’ll have had a great deal of experiencing doing so with support from a medication.
Why Don’t People Like Medication Assisted Treatment?
One of the most common arguments against MAT programs is that they simply replace one opioid with another. This is true, but the argument relies on the false idea that all opioids are equally bad for you and your mental health.
Abuse – Many opioid abuse treatment drugs are themselves opioids. Both buprenorphine and methadone are opioids. This allows them to interact with the opioid receptors in the brain, relieving cravings and soothing the need for more drug without withdrawal symptoms. However, this also means there is potential for abuse. Methadone and buprenorphine can each be injected to get a light high, similar to that of heroin. However, doctors are very aware of this problem. The most common MAT drugs include opioid agonists such as Naloxone, which help to prevent users from abusing them.
Addiction – Anyone taking a drug for a prolonged period of time will become physically dependent on that drug. It is still possible to become addicted to the drugs that were used to treat the original addiction. You will suffer withdrawal symptoms when going off a medication such as methadone or buprenorphine. But instead of the severe withdrawal you get from immediate cessation of opioid use, clients are tapered off the drug gradually.
While it’s true that MAT drugs do replace one opioid with another, the replacement opioids are safer, controlled in dosage, and work to heal. Rather than simply getting the individual high, drugs like buprenorphine and methadone work to control cravings, allow people to go into treatment, go back to work, and stop spending their time, money, and energy obsessing over a much more dangerous drug.
How Does Medication Treat Substance Use Disorder?
Medication assisted treatment works by substituting the opioid drug in the blood, reducing its impact, and reducing its harm. Rather than allowing individuals to inject themselves with an unknown volume of varying strength opiate or take numerous pills, a prescription medication-assisted treatment program ensures that individuals take a steady and controlled dose that works to combat cravings and symptoms without causing a high, many adverse physical side-effects, and without risk of disease or overdose.
MAT drugs typically work to interact with opioid receptors and stop withdrawal symptoms while working to break the psychological link between taking a drug and feeling a high. Some also work to prevent individuals from relapsing because, as opioid antagonists or agonists, they actively prevent opioids from getting individuals high and may actually force you into withdrawal if you do take an opioid. This is sometimes important, because if you have a long period of being clean, you may easily overdose when relapsing, because your tolerance has greatly reduced.
Medication-assisted treatment for opioid use disorder is accepted to the point where the CDC is running a long study on it. It’s also been linked to increased lengths of recovery and reduced rates of relapse in patients who continue maintenance therapy. That’s important considering one of the primary struggles of addiction treatment is maintaining results for years when patients don’t continue to seek out therapy and maintenance. It’s also important for you, because it means that it will help you to recover.
Recovering with Medication Assisted Treatment
While medication-assisted treatment is widely accepted as having a positive impact, especially over no treatment, it isn’t for everyone. A MAT program will include screening and analysis to determine if you are a suitable candidate for medication.
For example, you must have an official diagnosis of an addiction to opiates, must be fully willing to comply with prescription instructions, must have sufficient education on alternative options, and must not have any physical problems medication could exacerbate. You may not qualify for MAT if you have a history of abusing prescription medication, are addicted to a substance that does not have an FDA approved MAT drug, do not have strong motivation to recover, or have a physical condition that could be exacerbated by a drug.
If you’re looking into treatment programs, MAT may be a powerful step in the right direction. However, you definitely will need a professional assessment to determine if MAT is truly right for you.