An Overview of Medication Assisted Treatment in Ohio
Substance and alcohol use disorders are serious social problems that damage families and society at large. The reasons that someone becomes dependent on intoxicating substances are many, and quitting your drug of choice is hard in the best of circumstances. Many people are unable to do it without help and support.
That’s why White Light Behavioral Health strives to provide people in the Columbus community with the assistance and stability that they need to make healthier choices and face life clean and sober. We want to be your safe haven as you weather the storm of overcoming substance use disorder.
However, not all clients, use disorders, or approaches to treatment are the same. Sometimes, you also need medical support to control the effects of withdrawal and curb cravings that lead to relapse. A medication-assisted treatment program (MAT) is designed to do just that.
What Is Medication-assisted Treatment?
MAT is an evidence-based drug treatment protocol that’s used during the detox and recovery process. It’s particularly beneficial for managing severe withdrawal symptoms and preventing the cravings that often lead to relapse.
Medication assistance is especially effective for addressing opioid and alcohol use disorders, which are a consequence of using two of the more tenacious substances to quit. Both intoxicants have an average relapse rate of 72% to 88%, with some recent findings suggesting opioid relapse rates as high as 91%. Alcohol and opioids also cause substantial physical and emotional harm if use continues.
However, MAT should never be attempted without strict medical supervision.
How MAT Works
Contrary to popular misconceptions, MAT doesn’t merely trade one addiction for another. When properly administered under supervision from a licensed, qualified addiction specialist, medication-assisted treatment allows the client to fully experience life without the anchor that physical and emotional dependence on drugs creates.
Medication-assisted treatment works in combination with techniques like behavior modification and other clinical therapies to provide a holistic approach to substance use disorder treatment. The medications curb drug cravings by working on the same portions of the brain that are altered by chronic, long-term drug or alcohol use while the therapy addresses the contributing factors to your use disorder.
Many people use alcohol and drugs to cope with an undiagnosed mental illness, so diagnosis and treatment for co-occurring mental health conditions are crucial. MAT is available in conjunction with other treatment options, including partial hospitalization (PHP), inpatient, and outpatient programs. Each course of treatment is tailored to an individual’s circumstances and needs for a comprehensive, client-centered approach.
Benefits and Disadvantages of Treatment With Medication Assistance
The most obvious benefit of choosing MAT as part of your rehabilitation program is that it allows you to focus on your recovery without the pain and discomfort of detox. It does so by blocking the euphoric effects of drug or alcohol use while preventing the cravings and other withdrawal symptoms that keep you using.
MAT also prevents the risks that come from engaging in activities associated with illicit drug use, like criminal acts or using more dangerous street drugs. That’s in addition to added dangers from health conditions like HIV and hepatitis from sharing needles or heart and liver damage from continued alcohol use. Your risk of death from overdose is also substantially decreased.
Potential Disadvantages to MAT
The disadvantages to drug treatment with medication assistance are few, and they are substantially less dangerous than continuing in active drug or alcohol addiction. One primary disadvantage of MAT is that you need to find an addiction treatment center that’s authorized to dispense medications used during this treatment. You cannot obtain these medications over the counter.
There’s also a slight possibility of side effects from some of the medications. These can include:
- Constipation
- Nausea
- Headache
- Respiratory distress
- Sexual dysfunction
However, most of these symptoms are minimal and usually dissipate shortly after the medication is administered. There is a slight risk of abuse or dependence, which can usually be combatted with proper administration and by slowly decreasing the dosage over time.
Indications for MAT Treatment
The decision to include MAT as part of your treatment depends in part on your condition, your understanding of the pros and cons of this option, and the conclusion of your treatment specialist after they examine you. Success also depends on your mindset and motivations for full, long-term recovery. While everyone is different, you’re generally a good candidate for medication-assisted treatment if you have a:
- Severe or long-term use disorder
- History of unsuccessful tries to quit
- Substantial danger of relapse
- Treatment center where you can obtain your medications
Medications Used for Medication-assisted Treatment
Aside from the practical reasons that MAT must be administered and supervised by a qualified medical professional, there are legal and compliance guidelines to consider. The medications used in medication-assisted treatment are effective but potent controlled substances.
There are several medications that are approved for use in MAT programs, specifically to manage opioid or alcohol use disorders (AUD).
Buprenorphine
Better known under the brand name Suboxone, buprenorphine is a partial opioid agonist. This means that it produces some of the same effects as opioids, and it impacts the same portions of the brain, but it does so in a more moderate, manageable fashion. In other words, it keeps you from craving the drug without the associated “high.”
Buprenorphine is administered in tablet form or as a sublingual medication at an approved medical facility. Mild or more advanced clients can also take their prescriptions once they return home, but regular checks and medical supervision are still required.
Methadone
Methadone is a full opioid agonist, which means that it affects the same regions of your brain that are impacted by opioids and has the same chemical composition. It also blocks pain receptors. However, it doesn’t produce the high that you’d experience from other opiate-based drugs.
Because of the risk of abuse, this drug is available only by prescription through an accredited treatment center or program. Methadone is available in pill, liquid, or powder form.
Naltrexone
Also dispensed under the brand name Vivitrol in its injectable form, naltrexone blocks the euphoric effects of opioids by binding to the opioid receptors in the brain. It is also used to treat AUD.
It’s available in pill form, but treatment shouldn’t be started until all opioids are gone from your system. You should avoid taking naltrexone in conjunction with other MAT medications or opiates because it reduces opioid tolerance. When used for treating alcohol use disorder, it blocks the intoxicating effects of drinking.
Naloxone
Naloxone works as an opioid antagonist, meaning that it binds to opioid receptors while producing an opposing effect. This makes Naloxone effective for overdose prevention when used as an emergency treatment when an opioid overdose is suspected. Furthermore, there are no adverse effects in those who don’t have an opiate in their bloodstream. Naloxone is often carried by first responders. It can be administered by injection or as a nasal spray.
Acamprosate
Acamprosate is a central nervous system depressant (CNS) medication that is often sold under the brand name Campral. It has become standard for treating severe or long-term AUD. It doesn’t block alcohol intoxication or prevent cravings like naltrexone. Instead, it slows hyper-excitability during detoxification and normalizes brain function in long-term alcohol users who have achieved sobriety. It’s administered in pill form, which must be taken at the same time each day and in an unbroken state.
Disulfiram
Better known under its brand name Antabuse, disulfiram causes very unpleasant side effects if alcohol is used while taking it. It’s meant as a deterrent to drinking alcohol by making the user feel very sick if they drink while under the influence of disulfiram. In fact, disulfiram shouldn’t be taken within 12 hours of alcohol consumption because of the unpleasant side effects. Disulfiram is dispensed in tablet form, and the medication can be crushed and mixed with a non-alcoholic liquid to make it easier to take.
What to Expect from Drug or Alcohol Rehab
Whether you’re staying at an inpatient center or undergoing outpatient care, the first step of any rehab is detox. It’s important to get all traces of drugs or alcohol out of your system so that your care provider can fully assess your condition and devise a course of treatment.
Equally important is to move through this phase with medical supervision because of the unpleasant effects of withdrawal as well as the possible physical and mental health implications of detox. Withdrawal symptoms can be painful and cause great discomfort. In the case of alcohol withdrawal, they can also be fatal.
Signs of drug or alcohol withdrawal are both physical and emotional, and they vary from person to person. The length and severity depend on the length and severity of your use disorder, general health, and other contributing factors.
They include:
- Anxiety
- Depression
- Sleep disturbance
- Nausea and vomiting
- Headache
- Irritability
- Hyperactivity
- Lethargy
- Diarrhea
- Intense drug or alcohol cravings
- Profuse sweating
- Hand or head tremors
This phase starts within six hours of your last drink or dose. It lasts between 24 and 46 hours, but emotional symptoms can linger for up to a week after detoxifying.
The next phase of treatment is the active phase. You’ll first undergo an evaluation to determine if MAT is appropriate for your situation and the best course of medication.
If you’re staying at the facility as part of your rehab program, you’ll settle in and begin treatment the following day. Outpatient clients will receive instructions about where and when to attend their first education and therapy sessions.
Inpatient or partial hospitalization clients will typically remain in their facility for 30 to 90 days. Treatment includes individual counseling to uncover and address comorbidities, such as co-occurring mental health disorders. Your therapist will also help you address triggers and stressors that are associated with your use disorder, including family history, mental or physical health problems, past traumas, and other contributing factors. You’ll learn how to identify triggers and cope with temptation in the future, and you’ll incorporate various tools and techniques for making healthier life choices.
Many of our clients also respond well to group therapy. This provides an opportunity to bond with other people who are in recovery, share experiences and coping mechanisms, and learn that you’re not alone in your struggles.
These therapeutic resources are also available to outpatient clients, but sessions may be weekly or monthly rather than daily. This option is indicated for those with less severe or short-term use disorders. The medication-assisted portion of treatment will begin as soon as you’re detoxed from drugs or alcohol and in accordance with whatever medication approach is indicated for your situation and wellness goals.
Whichever treatment program you enter, MAT may be part of a long-term approach to relapse prevention. That means you will still need to report to our center to obtain medications. Regular meetings with your counselor will continue as long as necessary. You might also benefit from ongoing aftercare and recovery support programs, such as AA or NA meetings. These 12-step programs provide additional peer-to-peer support from others who understand.
Remember, recovery is an ongoing process, not a destination! Life is always going to be filled with stress and temptations. The goal is to use the tools and support mechanisms available through our treatment center to maintain long-term sobriety.
How to Find Medication-assisted Treatment in Ohio
Choosing to seek treatment for substance use disorder is one of the most difficult and important decisions you’ll make. However, recovery is an ongoing process that requires knowledge, support, and motivation if you want to make lasting changes in your life.
At White Light Behavioral Health, we strive to provide the first two components so that you can remain focused and motivated on the road to long-term recovery. It’s never too late to start over.
If you or someone you care about in the Columbus, Ohio area is struggling with substance use disorder, contact us today to learn more about our medication-assisted treatment and other programs.
