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Medication-assisted Treatment (MAT) For Addiction, Meaning, Benefits, How It Works

Medication-Assisted Treatment (MAT) is a comprehensive approach used to treat addiction by combining FDA-approved medications with counseling and behavioral therapies. This method addresses both the physical and psychological aspects of addiction, making it a balanced and sustainable option for long-term recovery. MAT is tailored to individual needs, treating disorders related to opioids, alcohol, and nicotine, and is effective in reducing cravings, preventing relapse, and stabilizing brain function and behavior.

The benefits of Medication-Assisted Treatment are significant and multifaceted. MAT has higher success rates compared to traditional treatment methods, as it effectively reduces cravings and alleviates withdrawal symptoms. This not only makes the initial stages of recovery more manageable but also supports sustained abstinence and lowers the risk of relapse. Additionally, MAT enhances the overall quality of life by improving mental health, relationships, job performance, and psychological well-being.

Medication-Assisted Treatment works by integrating medications that alleviate withdrawal symptoms and reduce cravings with counseling and behavioral therapies. For example, drugs like methadone and buprenorphine are used for opioid use disorders, while naltrexone is effective for both opioid and alcohol use disorders. Nicotine Replacement Therapies (NRT) help manage withdrawal symptoms and cravings for those with nicotine dependence. By addressing both the physiological and psychological aspects of addiction, MAT supports individuals in achieving and maintaining long-term recovery.

What is Medication-Assisted Treatment (MAT)?

what is mat

Medication-Assisted Treatment (MAT) is a holistic strategy designed to combat addiction through the integration of FDA-approved medications and therapeutic counseling. This dual approach targets both the physiological and psychological facets of addiction, providing a more balanced and enduring path to recovery. 

The primary goal of MAT is to help individuals achieve and maintain long-term recovery by reducing cravings, preventing relapses, and mitigating withdrawal symptoms. By integrating medication with therapy, MAT aims to restore normalcy to brain function and behavior, thereby enhancing the individual’s ability to fully engage in treatment and recovery.

MAT employs various medications tailored to different types of substance use disorders. This integrated approach not only improves treatment outcomes but also enhances the overall quality of life for individuals in recovery by promoting mental health and stability, reducing the risk of relapse, and lowering the rates of overdose fatalities.

What are the Types of Medication-Assisted Treatment?

Medication-Assisted Treatment (MAT) encompasses various medications tailored to treat specific substance use disorders, including opioids, alcohol, and nicotine. Each medication works uniquely to either alleviate withdrawal symptoms, reduce cravings, or block the euphoric effects of the abused substance. This approach not only aids in the immediate detoxification process but also supports long-term recovery by stabilizing brain function and behavior.

1. Opioid Use Disorder Medications

Medications for opioid use disorder aim to reduce cravings, alleviate withdrawal symptoms, and block the euphoric effects of opioids. According to Oesterle, T. S. et al. 2019, “Medication-Assisted Treatment for Opioid-Use Disorder,” these medications enable individuals to engage more fully in therapy and recovery activities, offering a stable path toward long-term sobriety and improved quality of life.

  • Methadone: Methadone is a long-acting opioid agonist primarily used to treat opioid use disorders. It works by reducing cravings and withdrawal symptoms, allowing individuals to engage more fully in therapy and recovery activities. Methadone is typically administered in specialized clinics due to its potential for abuse and the need for close monitoring.
  • Buprenorphine: Buprenorphine is a partial opioid agonist that helps mitigate opioid withdrawal symptoms and cravings. Its “ceiling effect” limits the risk of overdose, making it a safer alternative to methadone. Buprenorphine is prescribed in various forms, including sublingual tablets, buccal films, implants, and extended-release injections. Products like Suboxone combine buprenorphine with naloxone to further reduce abuse potential.
  • Naltrexone: Naltrexone is an opioid antagonist used to treat both opioid and alcohol use disorders. For opioid addiction, it blocks the euphoric effects of opioids, thereby reducing the incentive to use them. Naltrexone is available as an oral tablet or a monthly extended-release injection, making it a versatile option for long-term maintenance therapy.

2. Alcohol Use Disorder Medications

Medications for alcohol use disorder help manage withdrawal symptoms, reduce cravings, and discourage alcohol consumption. According to Robertson AG, Easter MM, Lin H, Frisman LK, Swanson JW, Swartz MS., et al. 2018, “Medication-Assisted Treatment for Alcohol-Dependent Adults With Serious Mental Illness and Criminal Justice Involvement: Effects on Treatment Utilization and Outcomes,” these medications support long-term abstinence and improve treatment outcomes by stabilizing brain chemistry disrupted by chronic alcohol use.

  • Disulfiram (Antabuse): Disulfiram is one of the first medications approved for treating alcohol use disorder. It works by causing unpleasant effects such as nausea and flushing when alcohol is consumed, thereby acting as a deterrent. This medication is effective in helping individuals who have a high motivation to remain abstinent from alcohol.
  • Acamprosate (Campral): Acamprosate is used to treat alcohol dependency by reducing withdrawal symptoms like insomnia, anxiety, and restlessness. It works by stabilizing the chemical balance in the brain that is disrupted by chronic alcohol use, thereby supporting long-term abstinence.
  • Naltrexone: For alcohol use disorder, naltrexone helps reduce the rewarding effects of alcohol, thereby decreasing the urge to drink. It is available in both oral and injectable forms and has been shown to improve treatment outcomes by supporting sustained abstinence and reducing the risk of relapse.

3. Nicotine Dependence Medications

Nicotine dependence medications, such as Nicotine Replacement Therapies (NRT), help manage withdrawal symptoms and reduce cravings associated with quitting smoking. These treatments double the chances of successfully quitting by providing controlled amounts of nicotine, according to Giulietti, F., Filipponi, A., Rosettani, G., et al. et al. 2020, “Pharmacological Approach to Smoking Cessation: An Updated Review for Daily Clinical Practice.”

  • Nicotine Replacement Therapies (NRT): Nicotine Replacement Therapies (NRT) include products such as patches, gum, lozenges, nasal sprays, and inhalers that provide controlled amounts of nicotine to help manage withdrawal symptoms and cravings associated with quitting smoking. NRTs double the chances of successfully quitting smoking by gradually reducing nicotine dependence, making the transition to complete abstinence more manageable.

What are the Benefits of Medication-Assisted Treatment?

benefits of MAT

Medication-Assisted Treatment (MAT) offers a comprehensive approach to treating substance use disorders by combining FDA-approved medications with counseling and behavioral therapies. This integrated method addresses both the physical and psychological aspects of addiction, significantly enhancing treatment outcomes and supporting sustainable recovery. Below are the key benefits of MAT:

1. Higher Success Rates

MAT is associated with higher success rates in maintaining long-term recovery than traditional treatment methods. Individuals on MAT are more likely to remain in treatment and achieve sustained abstinence from substance use. According to Feelemyer J, Des Jarlais D, Arasteh K, Abdul-Quader AS, Hagan H., et al. 2014, “Retention of participants in medication-assisted programs in low- and middle-income countries: an international systematic review,” Medication-assisted treatment programs achieve an average 50% retention rate.

2. Reduced Cravings and Withdrawal Symptoms

Medications used in MAT effectively reduce cravings and alleviate withdrawal symptoms, making the early stages of recovery more manageable. According to Arms L, Johl H, DeMartini J., et al. 2022, “Improving the utilisation of medication-assisted treatment for alcohol use disorder at discharge,” by minimizing these physical and psychological discomforts, MAT supports individuals in their efforts to quit and reduces the likelihood of relapse.

3. Enhanced Quality of Life

By addressing the debilitating symptoms of withdrawal and cravings, MAT helps individuals regain control over their lives. This improvement extends to better mental health, enhanced relationships, increased job performance, and overall psychological well-being, leading to a more balanced and fulfilling life. According to Carter M, Boyd J, Bennett T, Baus A., et al. 2023, “Medication Assisted Treatment Program Policies: Opinions of People in Treatment,” MAT saves lives and enhances the quality of life for people in recovery.

4. Safety and Overdose Prevention

MAT medications, such as buprenorphine and methadone, are safer alternatives to illicit opioids. These medications are administered in controlled doses to prevent misuse and reduce the risk of overdose. Au, V.Y.O., Rosic, T., Sanger, N. et al. 2021, “Factors associated with opioid overdose during medication-assisted treatment: How can we identify individuals at risk?” has shown the life-saving potential of MAT. This safety aspect is particularly crucial in reducing opioid overdose fatalities and ensuring safer long-term recovery.

5. Comprehensive Treatment Approach

MAT is often part of a broader treatment program that includes psychological counseling, peer support, and lifestyle changes. This holistic approach addresses the root causes of addiction, providing a more robust framework for recovery and making relapse less likely.

6. Tailored to Individual Needs

The flexibility in the types of medications and treatment plans allows personalized treatment tailored to the individual’s needs. Whether dealing with opioid, alcohol, or nicotine dependence, there is likely a MAT option suitable for the individual’s condition, ensuring more effective and personalized care.

What are the Applications of Medication-Assisted Treatment?

Medication-Assisted Treatment (MAT) is widely applied in the treatment of various substance use disorders, offering a balanced approach that combines medication with counseling and behavioral therapies. MAT addresses both the physiological and psychological aspects of addiction, making it a versatile and effective option for many individuals. Below are the primary applications of MAT:

  • Opioid Use Disorder 
  • Alcohol Use Disorder 
  • Nicotine Dependence 
  • Other Substance Use Disorders 

What are the Myths About MAT?

MythExplanation
MAT Replaces One Addiction with AnotherThis misconception arises from the fact that MAT involves the use of medications that are addictive. However, these medications are administered in controlled, regulated doses to stabilize the patient and prevent misuse.
MAT is Only Substituting One Drug for AnotherUnlike active addiction, MAT provides medications to reduce cravings and withdrawal symptoms under medical supervision, helping individuals regain stability and functionality in their lives.
MAT is a Quick FixMAT is part of a comprehensive treatment plan that includes counseling and behavioral therapies. Recovery is a long-term process, and MAT helps manage the physical aspects of addiction, supporting the overall recovery journey.
MAT is Not EffectiveExtensive research and numerous studies have shown that MAT significantly improves treatment outcomes, reduces the risk of relapse, and supports long-term recovery when combined with other therapeutic interventions.
MAT is Only for Severe CasesMAT is beneficial for a wide range of substance use disorders, not just severe cases. It helps anyone struggling with addiction by managing withdrawal symptoms and reducing cravings, regardless of the severity of their condition.
MAT is Not Safe During PregnancyMAT is considered safer than untreated opioid addiction during pregnancy. Medications like buprenorphine are recommended as they pose a lower risk to both the mother and the fetus compared to continued opioid use.
MAT Increases Risk of OverdoseWhen administered correctly, MAT reduces the risk of overdose. For example, buprenorphine has a ceiling effect that lowers the risk of respiratory depression, making it safer than many opioids used in active addiction.
MAT Patients Cannot Achieve True SobrietyMAT helps patients achieve stability and engage in therapy and recovery activities. It supports long-term sobriety by addressing the physical aspects of addiction, allowing patients to focus on behavioral and psychological recovery.
MAT is Expensive and Not Covered by InsuranceWhile costs vary, many health insurance plans cover MAT, including Medicaid and Medicare. Additionally, the overall cost of MAT is often lower than the costs associated with untreated addiction, such as healthcare expenses and lost productivity.
MAT Leads to Social StigmaWhile some people view MAT as controversial, increasing public awareness and education about its effectiveness are helping to reduce stigma. Numerous health organizations endorse MAT as a legitimate and effective treatment for substance use disorders.

What are the Negatives and Challenges of Medication-Assisted Treatment?

While Medication-Assisted Treatment (MAT) is highly effective in treating substance use disorders, it has its challenges and potential drawbacks. According to Kampman K. K. et al. 2019, “General introduction: Issues and perspective on medication-assisted treatment,” the following are a few major concerns about MAT:

  1. Risk of Dependency on MAT Medications
  2. Side Effects including nausea, vomiting, constipation, and drowsiness
  3. Financial Cost of MAT
  4. Stigma
  5. Limited Accessibility for individuals in remote areas 
  6. Interaction with Other Medications often complicates treatment
  7. It is not a Standalone Solution; it needs to be combined with counseling and behavioral therapies for the required results
  8. Special Populations, such as pregnant women and the elderly, require tailored approaches

Where Can You Find Medication-Assisted Treatment?

Medication-Assisted Treatment (MAT) is found in a variety of healthcare settings to ensure accessibility and comprehensive care for those seeking treatment for substance use disorders.

  1. Addiction Treatment Centers
  2. Outpatient Clinics
  3. Primary Care Physicians
  4. Hospitals
  5. Telemedicine Services
  6. Veterans Affairs Medical Centers
  7. Public Health Departments

What is the Effectiveness of Medication-Assisted Treatment?

Medication-Assisted Treatment (MAT) is widely recognized as an effective approach for treating substance use disorders, including opioid, alcohol, and tobacco addictions. Numerous studies and clinical trials support MAT’s efficacy. Mancher M, Leshner AI, et al. 2019, “Medications for Opioid Use Disorder Save Lives,” have demonstrated that MAT significantly reduces opioid cravings, alleviates withdrawal symptoms, and lowers the rates of relapse. It also improves treatment retention and decreases the likelihood of overdose fatalities. The effectiveness of MAT extends to treating alcohol use disorders with medications like disulfiram, acamprosate, naltrexone,e and nicotine dependence through nicotine replacement therapies.

Endorsement from the Substance Abuse and Mental Health Services Administration (SAMHSA) and other organizations further validates MAT’s effectiveness. SAMHSA advocates for MAT as a standard treatment option due to its ability to address both the physiological and psychological aspects of addiction. This comprehensive approach not only aids in achieving long-term recovery but also enhances the overall quality of life for individuals battling substance use disorders.

Can MAT be used for all types of addiction?

MAT is used to treat opioid, alcohol, and nicotine dependence, with specific medications tailored for each type of addiction.

Is MAT safe during pregnancy?

MAT is considered safer than untreated opioid addiction during pregnancy, with medications like buprenorphine recommended for their lower risk.

Do you have to take MAT medications forever?

No, the duration of MAT varies depending on individual needs and progress, and it is typically tapered off under medical supervision.

How can Acceptance and Commitment Therapy (ACT) enhance the effectiveness of Medication-Assisted Treatment (MAT) for addiction?

Acceptance and Commitment Therapy (ACT) can enhance the effectiveness of Medication-Assisted Treatment (MAT) for addiction by helping individuals develop psychological flexibility and commitment to behavior change. ACT focuses on accepting difficult emotions and thoughts rather than avoiding them, which can reduce the psychological distress associated with addiction recovery. When combined with MAT, which addresses the physical aspects of addiction, ACT provides a holistic approach that supports long-term recovery. By helping individuals align their actions with their values and goals, ACT complements the stabilizing effects of MAT, leading to more sustainable recovery outcomes.

What are the benefits and limitations of using MAT in conjunction with other addiction therapies like ECT and ACT?

The benefits of using Medication-Assisted Treatment (MAT) in conjunction with other addiction therapies like Electroconvulsive Therapy (ECT) and Acceptance and Commitment Therapy (ACT) include a comprehensive approach to addiction treatment that addresses both physical and psychological aspects. MAT helps manage withdrawal symptoms and cravings, making it easier for individuals to engage in other therapies. ECT can address severe co-occurring mental health conditions, while ACT helps individuals cope with emotional and psychological challenges. However, the limitations include the need for careful coordination among different treatment modalities and the potential for varying levels of effectiveness depending on the individual.

Does insurance cover MAT?

Many health insurance plans, including Medicaid and Medicare, cover MAT, making it more accessible for those in need.

Can you receive MAT through telemedicine?

Many providers offer MAT through telemedicine services, increasing accessibility for those unable to visit healthcare facilities in person.

Ryan Wakim MD
Author
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Dr. Wakim is a board-certified psychiatrist with a passion for and expertise in addiction, mood disorders, trauma-related disorders and the subspecialty of interventional psychiatry. He obtained his medical degree from West Virginia University where he also completed his residency training, finishing as chief resident. Dr. Wakim co-founded and served as the CEO of Transformations leading to a successful merger with Shore Capital in May 2021. He is purpose driven towards improving the standard of and removing stigma related to behavioral healthcare. Dr. Wakim enjoys golf, traveling and time spent with his two dogs, Lulu and Rayna.

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