Medication-Assisted Treatment (MAT) is an evidence-based, comprehensive approach to detoxification and substance abuse treatment that combines the use of medications with counseling and behavioral therapies.
It is commonly used to treat opioid use disorder (OUD) but can also be effective for other substance use disorders (SUDs) such as alcohol or nicotine dependence. MAT has been shown to improve treatment outcomes and reduce the risk of relapse, making it an important component of comprehensive addiction treatment programs.
Detoxification, also known as detox, is the process of allowing the body to rid itself of substances while managing withdrawal symptoms.
It is typically the first step in substance abuse treatment. MAT can be used during detoxification to ease withdrawal symptoms and cravings, which can be intense and uncomfortable, and help individuals transition into ongoing treatment.
The primary medications used in MAT for opioid dependence are methadone, buprenorphine, and naltrexone.
Methadone is a long-acting opioid agonist that helps to stabilize individuals by reducing cravings and withdrawal symptoms. It is administered daily in specialized clinics. Buprenorphine is a partial opioid agonist that also reduces cravings and withdrawal symptoms but has a lower risk of overdose compared to methadone. It can be prescribed in office-based settings by specially trained physicians. Naltrexone is an opioid antagonist that blocks the effects of opioids and can be used to prevent relapse once individuals have completed detoxification.
In addition to managing withdrawal symptoms, MAT addresses the underlying physiological changes in the brain caused by substance abuse. Prolonged substance use can disrupt the brain’s reward system, leading to a dysregulated state where individuals experience intense cravings and diminished control over their substance use. MAT medications help restore balance to the brain’s reward system, allowing individuals to regain control over their cravings and addictive behaviors.
MAT is not intended to be a standalone treatment but is most effective when combined with counseling and behavioral therapies. These therapies can help individuals develop coping skills, address underlying issues contributing to substance use, and make positive changes in their lives. Counseling may include individual therapy, group therapy, family therapy, or a combination of these approaches. Behavioral therapies such as cognitive-behavioral therapy (CBT) and contingency management (CM) are commonly used in conjunction with MAT to reinforce positive behaviors and promote recovery.
One of the main advantages of MAT is its ability to reduce the risk of relapse and overdose. Opioid addiction, in particular, has a high relapse rate, with many individuals returning to drug use after detoxification. Research has shown that MAT significantly improves treatment retention, reduces illicit drug use, and decreases the risk of overdose and associated mortality. By stabilizing individuals and reducing cravings, MAT provides a foundation for long-term recovery.
MAT is also associated with a range of other benefits. It has been shown to improve overall health outcomes, reduce the transmission of infectious diseases (such as HIV and hepatitis C) associated with injecting drug use, decrease criminal activity, and improve social functioning. By helping individuals regain stability in their lives, MAT can enhance their ability to maintain employment, engage in positive relationships, and contribute to their communities.
It is important to note that MAT is not a one-size-fits-all approach. The choice of medication and treatment plan should be individualized based on factors such as the type and severity of substance use disorder, medical history, and individual preferences. Regular monitoring and adjustments to the medication dosage may be necessary to ensure optimal treatment outcomes.
While medications play a crucial role in MAT, they are most effective when combined with behavioral therapies. The combination of medication and therapy helps address the complex nature of substance use disorders and promotes holistic recovery.
Some common behavioral therapies used in conjunction with MAT include:
Cognitive Behavioral Therapy (CBT)
Helps individuals identify and modify dysfunctional thought patterns and behaviors related to substance use. CBT teaches coping skills, relapse prevention strategies, and provides tools for managing triggers and cravings.
Contingency Management (CM)
Provides positive reinforcement, such as rewards or vouchers, for maintaining abstinence and engaging in treatment-related activities. CM encourages individuals to make healthier choices and stay motivated in their recovery journey.
Motivational Interviewing (MI)
A client-centered counseling approach that helps individuals explore their ambivalence about change and strengthen their motivation to overcome substance use. MI promotes self-reflection, goal-setting, and decision-making.
Group Therapy
Allows individuals to connect with others who have similar experiences, share support, and learn from one another. Group therapy provides a sense of community, validation, and social reinforcement for recovery.
Benefits of Medication-Assisted Treatment
Reduced Cravings and Withdrawal Symptoms
Medications used in MAT help to alleviate the intense cravings and withdrawal symptoms associated with substance use disorders. This reduces the likelihood of relapse and increases the chances of successful recovery.
Harm Reduction
MAT can minimize the risks associated with illicit drug use. For individuals with OUD, medications like methadone or buprenorphine can be provided in a controlled setting, reducing the need for dangerous, unregulated opioid use.
Improved Retention in Treatment
MAT has been shown to improve treatment engagement and retention rates. By addressing the physical symptoms of addiction, medications can help individuals stay committed to their recovery process and benefit from the accompanying behavioral therapies and support services.
Lower Mortality Rates
MAT has been associated with reduced mortality rates among individuals with OUD. Medications like methadone and buprenorphine stabilize individuals, decreasing the risk of overdose and other opioid-related complications.
Enhanced Psychological Stability
By alleviating withdrawal symptoms and cravings, MAT can provide individuals with a more stable foundation for engaging in therapeutic interventions. It allows them to focus on addressing the underlying psychological and behavioral aspects of their addiction.
Despite the numerous benefits of MAT, it is still underutilized in many settings.
Stigma, lack of awareness, limited access to healthcare providers with MAT training, and regulatory barriers are some of the factors that contribute to its underutilization. Efforts to expand access to MAT involve training healthcare providers, reducing regulatory barriers, integrating MAT into primary care settings, and educating the public about its effectiveness.
Align Recovery Centers welcomes the use of Medication Assisted Treatment, where appropriate, to relieve the physical distraction while augmenting its therapeutic goals to help our clients achieve lasting recovery.
Dana, with over 20 years in addiction therapy and counseling, is the Executive Director at Align Recovery Centers. Holding a B.S. in Human Services and an M.A. in Counseling & Psychology, she’s both an Associate Marriage and Family Therapist and a Substance Use Disorder Certified Counselor. Specializing in DBT and CBT, Dana effectively manages both residential and outpatient programs. Her interests include gardening, cooking, and delving into psychological research in her spare time.