Medication Assisted Treatment (MAT)
Medication-assisted treatment (MAT) is the use of medications in combination with counseling and behavioral therapies for the treatment of substance use disorders. For those with an opioid use disorder (OUD), medication addresses the physical difficulties that one experiences when they stop taking opioids. MAT can help to reestablish normal brain function, reduce substance cravings and prevent relapse. The longer in treatment, the more the individual will be able to manage their dependency and move toward recovery.
Treatment, not Substitution
Because methadone and buprenorphine are opioids, some people believe that treating addiction with these drugs simply substitutes one substance for another. Evidence-based treatment has proven that when patients take these medications as prescribed, they are more likely to maintain employment, avoid criminal behavior, and reduce their exposure to HIV by injection or substance-related high-risk sexual behaviors. They are also more likely to engage in counseling and other behavioral interventions that improve their recovery.
Behavioral Health Services
An important piece that is not widely understood is that medications are only part of a MAT approach. In true medication assisted treatment, the medications are “assisting” other components of treatment. To increase the benefit that individuals receive from psychosocial intervention, services should be best practice, which refers to a practice that has been heavily studied by researchers in well-designed scientific and clinical studies.
Examples Include: Cognitive Behavioral Therapy, Motivational Interviewing, Moral Re-conation Therapy, Peer and Recovery Support Services, Twelve Step Facilitation and Contingency Management.
Opioid Use Disorder
Methadone is a long-acting synthetic opioid agonist medication that can prevent withdrawal symptoms and reduce craving in individuals with opioid-dependence. It can also block the euphoric effects of illicit opioids. It has a long history of use in treatment of opioid dependence and is taken orally.
Buprenorphine is a synthetic opioid medication that acts as a partial agonist at opioid receptors, but does not produce the euphoria and sedation caused by heroin or other opioids. Buprenorphine is able to reduce or eliminate withdrawal symptoms associated with opioid dependence and carries a low risk of overdose. Buprenorphine is currently available in two forms that are taken sublingually (dissolves under the tongue) and subcutaneous (injection): (1) a pure form of the substance and (2) a more commonly prescribed formulation called Suboxone, which combines buprenorphine with the substance naloxone, an antagonist (or blocker) at opioid receptors.
Naltrexone is a synthetic opioid antagonist that blocks opioids from binding to the receptors and prevents the euphoric and sedating effects. Naltrexone itself has no subjective effects following detoxification and has no potential for abuse. Individuals should not use naltrexone if they are taking an opiate as they could experience sudden withdrawal symptoms. Those with low liver functioning and a history of depression should be carefully considered prior to induction.