Achieving sobriety after a lengthy period of addiction is a demanding process that often necessitates the use of multiple treatment methods. Medication assisted treatment, also known as MAT, is one of the most effective treatment approaches for alcohol and drug addiction. But what is medication assisted treatment? At its core, MAT therapy involves combining medications, counseling, and behavioral therapy. MAT tackles a substance use disorder on multiple levels and takes a holistic “whole person” approach to addiction treatment.
Medications help reduce withdrawal symptoms, cravings, and make the transition to total abstinence both physically and mentally easier. Counseling helps individuals come to terms with the underlying psychological issues behind their addictions, and behavioral therapy allows people to develop new skills and coping techniques to handle life in sobriety and avoid relapse. While any of these treatment modalities are helpful on their own, when they are combined in a medication assisted treatment program they are far more effective.
Why Medication Assisted Treatment is Necessary?
Drug addiction is responsible for thousands of deaths each year. In 2018, more than 67,300 people in the United States died of a drug overdose. In fact, overdoses have been increasing in the last decade. Drug overdoses have recently surpassed automobile accidents as the number one leading cause of premature death. While alcohol remains the most commonly abused recreational drug, opioid abuse has seen a particularly dramatic increase in recent years. Illegal “street drugs” like heroin as well as medical opioids such as fentanyl and oxycodone are responsible for the opioid epidemic. These substances not only pose a high risk of a life-threatening overdose, but they wreck lives and damage communities.
Unfortunately, even people who desire to quit using these substances often find it nearly impossible on their own. Individuals with substance use disorders are unable to exercise control of their own drug and alcohol habits, and many continue to do so for years despite a desire to stop. Substance abuse actually changes the brain chemistry in users’ brains, altering areas of the brain responsible for motivation and decision-making.
Psychological and interpersonal conditions, such as mental illness or an unstable life, can also make it more difficult to quit drugs and alcohol. For any individual suffering from a substance use disorder, there is rarely one single cause for addiction. There are generally multiple contributing factors to addiction, and proper addiction treatment involves assessing the individual’s unique needs and addressing all of them. Medication assisted treatment helps individuals using a two-pronged approach: it addresses addiction on a medical level but also helps individuals change their behavior and approach to living.
One of the main factors that contributes to people relapsing after getting sober is physical dependency. Individuals who are physically dependent on drugs and alcohol experience excruciating mental and physical withdrawal symptoms soon after stopping their substance abuse. Withdrawal symptoms can last for a long time, even months in the case of post-acute withdrawal syndrome. After only a short period of time, individuals who crave relief from these symptoms are driven to return to substance abuse.
Unfortunately, after a period of abstinence it is common for people to have reduced tolerance for their substance of choice. The result is that many individuals die of drug overdoses when they relapse. These deaths are, however, very much preventable. Behavioral therapy, counseling, and support groups can help people develop tools to avoid relapse, but often these treatments are more accessible and readily implemented for people who are receiving medical help for their withdrawal symptoms and cravings.
Why Medication Assisted Treatment Helps?
There is a myth that taking medications to deal with a drug addiction is merely substituting one drug for another. This is inaccurate. Individuals who are engaged in medication assisted treatment, an evidence-based practice, do so under careful medical supervision and follow strict guidelines. Moreover, the medications prescribed do not offer users the same pleasurable feelings of euphoria, or “high,” that recreational substances do. Medications prescribed during MAT are designed to reduce cravings and withdrawal symptoms. By eliminating the most excruciating withdrawal symptoms and mitigating cravings, medications can help individuals focus on treating other aspects of their addiction, from comorbid mental health conditions to interpersonal issues.
In certain cases, withdrawal without a medical intervention can be life-threatening. Unsupervised rapid withdrawal from alcohol or benzodiazepines can result in seizures, comas, or even death. It is far safer to wean off under careful medical supervision at a detox center, and certain medications can be prescribed to lessen the dangerous symptoms of withdrawal.
Opioids withdrawal, while not fatal, is so painful and debilitating that many people find it nearly impossible to handle more than a day without opioids. Medication assisted treatment allows them to experience the effects of withdrawal gradually. Ultimately, the goal is to taper off opioids entirely. However, some people stay on medications for years. There is nothing wrong with doing so. Medication assisted treatment policies and procedures recognize that every individual recovers from substance use disorder at their own pace. The goal of MAT is to help individuals develop a solid standing in sobriety and a variety of tools and coping strategies without letting withdrawal symptoms and cravings get in the way.
What Prescriptions are Used in MAT?
Medication Assisted Treatment for Opioid Use Disorder
For people with opioid use disorder, the most common medications doctors prescribe are methadone, buprenorphine, and naloxone.
Methadone, which is a synthetic opioid agonist, actually activates the same opioid receptors in the brain that recreational opioids work on. However, methadone operates far more slowly on these receptors, so users do not experience the same “high” that they do from illegal drugs. By activating these receptors to a limited degree, methadone reduces withdrawal symptoms and drug cravings. By switching from a recreational opioid to methadone, an individual may often find it far easier to taper their dose than they otherwise would.
Buprenorphine is a partial opioid agonist. Like methadone, it activates opioid receptors in the brain, but it does so far less than full opioid agonists. Medication assisted treatment stats have shown that buprenorphine therapy is just as effective as methadone treatment. Both substances mitigate cravings and withdrawal symptoms, allowing people to taper at a comfortable pace and pursue behavioral therapy simultaneously. The main difference lies in the drugs’ levels of accessibility. Buprenorphine can be prescribed by any physician, whereas methadone is only accessible in specialized treatment clinics.
Naloxone, unlike buprenorphine and methadone, is an opioid antagonist that works by blocking signals to opioid receptors in the brain. Naloxone can be used to reverse an opioid overdose. When individuals take it, it becomes physically impossible to get high from opioids. Those who take it while on opioids immediately enter withdrawal. Naloxone is very valuable for preventing unnecessary opioid overdose deaths, but it is also often combined with buprenorphine in therapeutic settings. Buprenorphine mixed with naloxone limits withdrawal even more, is extremely difficult to abuse, and makes relapse both impossible and deeply unpleasant.
Medications Used for Alcohol Use Disorder
The most common medications prescribed in the treatment of alcohol use disorder are naltrexone, disulfiram, and acamprosate.
Naltrexone is a substance use for treating alcoholism, though it is also effective for opioid addiction. Naltrexone blocks the effects of intoxication that occur when an individual drinks alcohol or takes opioids. It is therefore effective for people who need additional motivation to curb their drinking behaviors and avoid relapse.
Disulfiram is a medication that affects the way bodies process alcohol. People who use disulfiram in a medication assisted treatment program must be very committed to stopping their alcohol intake. Taking disulfiram causes people to be unable to process alcohol. People who drink using the substance experience heart palpitations, anxiety, heavy sweating, nausea, and vomiting. While some people may choose to drink while taking disulfiram, it can help many people think twice before beginning a relapse.
Acomprosate is another medication used for alcohol dependence. Rather than worsen the effects of drinking, acamprosate makes it easier for people to abstain from alcohol by promoting feelings of calm and relaxation. It also mitigates cravings and ultimately reduces an individual’s physical dependence on alcohol. Acamprosate is usually prescribed to people who have already begun the process of withdrawing from alcohol and need some additional support.
What to Expect with MAT
If you are asking, “How can I find medication assisted treatment near me?” your best bet is to reach out to local addiction treatment facilities. Medication assisted treatment is commonly used in intensive outpatient programs, medical detox centers, partial hospitalization programs, and inpatient treatment programs. It is the primary focus of any methadone treatment center or suboxone clinic as well. Enrolling in any one of these programs will enable you to begin working with psychiatrists and addiction counselors to begin the process of treating your substance use disorder.
Recovering from an addiction is a lifelong process. There is no “cure” for addiction. Nonetheless, MAT therapy is an effective treatment that has most people seeing benefits right away. Some of these benefits of medication assisted treatment include:
- Decreased likelihood of abusing opioids
- Lowered chances of dying from an overdose
- Reduction in criminal activity
- Decreased chances of transmitting infectious diseases
- Improved ability to function in social situations
- Higher chances of remaining in therapy longer
When beginning medication assisted treatment, individuals are expected to begin therapeutic work towards treating their addictions as well. Despite the name, it is important to understand that medication assisted treatment does not focus exclusively on the medical aspect of treatment. One of the primary benefits of MAT is that individuals find it easier to stay in treatment longer. Research has repeatedly shown that people who remain in treatment for longer periods of time are more likely to achieve long term sobriety. While medication offers valuable support, over time behavioral therapy and support groups are likely to provide the foundation and skill set that people need to rebuild healthy prosperous lives in sobriety.
Is MAT Allowed at Sober Living Homes?
Sober living homes provide individuals recovering from substance use disorders with a safe space to recover, develop community, and rebuild their lives. While sober living homes are often recommended as part of an aftercare plan for graduates of formal treatment programs, many people choose to enroll in sober living homes as a first line of defense against addiction. Structured sober living homes offer peer recovery programs that many find sufficient and effective. Many people also choose to enroll in outpatient programs while residing in a sober living home. While all sober living homes offer different resources and have different policies, they are a common commitment to helping people get sober.
For people enrolled in medication assisted treatment programs are generally accepted in most sober living homes. However, it is important to understand that sober living homes are not authorized to administer MAT themselves. Residents of sober living houses interested in MAT are required to seek the help of licensed medical professionals through partial hospitalization programs, outpatient programs, or clinics that specialize in MAT. Staff members of sober living homes can help by coordinating with case workers at these other programs. While sober living homes cannot provide MAT directly, they allow residents to pursue MAT for as long as it is deemed medically necessary.
In fact, sober living homes and MAT go hand in hand. Medication and behavior modification allow patients to make rapid strides toward sobriety, while sober living homes allow them a safe and supportive environment for their recovery. Engaging in medication assisted treatment while residing in a sober living home offers many additional benefits, including a sober social support system, involvement in support groups and 12-step programs, and career building resources. While both are effective on their own, sober living homes and medication assisted treatment work in tandem to offer individuals an even greater chance of recovery from addiction.