Medication Assisted Treatment

What Is Medication Assisted Treatment (MAT)?

The Substance Abuse and Mental Health Services Administration (SAMSHA) defines medication-assisted treatment (MAT), or medically assisted treatment, as medication, in conjunction with counseling and behavioral therapies, to give a “whole-person” approach to the treatment of substance use disorders. MAT is an essential and valuable part of comprehensive care choices provided to individuals who are chronically afflicted with alcohol and drug abuse.

Is Medication Assisted Treatment Effective?

Medication assisted treatment is one of the five evidence-based practices defined by the National Quality Forum (NQF), a nonprofit, nonpartisan organization that strives to improve health care. The NQF endorses methods and procedures developed by The Joint Commission and the National Council on Quality Assurance, amongst many other professional health care policy institutes. In addition to MAT being an evidence-based practice, proven and backed by research to be effective in recovery, the National Institute of Health (NIH) cites evidence that it improves rehabilitation outcomes for individuals struggling with addictive disorders. The treatment has proven to:

• Improve the individual’s survival
• Increase maintenance in treatment
• Decrease opiate abuse and criminal activity amongst those with substance use disorders
• Boost an individuals’ ability to attain and maintain employment
• Enhance delivery outcome with expecting women who struggle with a substance use disorder

What Are the Medications used in MAT?

All the medications used in MAT, sometimes referred to as medication treatment, are approved by the Food and Drug Administration (FDA). These authorized medications are provided to treat opioid addiction and alcohol addiction. MAT medications alleviate withdrawal symptoms and mental cravings that create chemical imbalances within the body and do not simply replace one drug for the other. Medical professionals considering these medications for alcohol or opioid treatment consider the individual’s treatment goals, preferences, and safety.

MAT Medications for Alcohol Addiction

• Acamprosate – brand name Campral, is an oral tablet for treating alcohol dependence used in recovery to prevent relapse and maintain abstinence. Chronic alcohol intake over a prolonged time can disrupt a various number of neurotransmitter systems in the brain, specifically the glutamatergic neurotransmission. Acamprosate works by targeting these glutamatergic receptors in the brain to regulate the physiological components that may entice relapse. It improves the underlying shifts in neurochemistry caused by excessive drinking and repairs the body’s equilibrium. The medication can be taken with commonly prescribed compounds and has no potential for abuse while decreasing the rate of alcohol consumption.
• Disulfiram – was the first medication approved by the FDA to treat alcohol addiction for those committed to sobriety. It is an oral tablet made to deter alcohol consumption and encourage abstinence by producing adverse effects to drinking alcohol. The undesirable effects usually start about 10 to 30 minutes after alcohol is ingested, discouraging the urge to drink. The reaction is dependent on the dosage of disulfiram and alcohol consumption. Still, it typically induces sweating, nausea, vomiting, chest pains, vertigo, uneasiness, confusion, blurred vision, head and neck throbbing, and weakness. Enthusiastic individuals who are motivated for treatment, devoted to abstinence, and follow and engage in their rehabilitation benefit the most from disulfiram.
• Naltrexone – treats alcohol use disorder and opioid use disorder. It is available in a pill form for alcohol addiction or intramuscular injection to treat alcohol or opioid use disorder. Naltrexone infuses with endorphin receptors that make one feel euphoric and restricts those feelings and effects of alcohol. It helps manage sobriety by diminishing alcohol cravings and creating sensitivity to alcohol intake. Like the acamprosate and disulfiram medications, naltrexone practically has no potential for abuse and cannot develop a tolerance.

MAT Medications for Opioid Addiction

• Buprenorphine – a semi-synthetic, regulated partial opioid, is available in various forms to treat opioid use disorder. Subutex, suboxone, zubsolv, bunavail, probuphine, and sublocade are all FDA-approved buprenorphine products. Buprenorphine has an abuse potential because of its partial opioid effect; for this reason, naloxone is added as a combination medication to diminish the possibility of misuse. Naloxone is an FDA-approved medication made to reverse an opioid overdose quickly. Buprenorphine is known to block the effects of opioids after being taken, aiding in successful maintenance by decreasing opioid abuse and diminishing the risk of relapse with its long-term substitution. Buprenorphine also aids in subduing symptoms of opioid withdrawal, diminishes cravings and dependency, and increases safety in cases of overdose.
• Methadone – a synthetic opioid, available in liquid, powder, and pill form, is used to treat opioid use disorder and pain management. The goal of methadone maintenance is to replace illegally used opioids, highly associated with mortality, with a legal synthetic opiate. It prevents opioid withdrawal symptoms, restricts the euphoric effect, lessens cravings, and decreases the risk of disease contracted by needle sharing. Methadone doses are precisely adjusted to fit the individual, and consultation is necessary in the case of adverse interaction with other medications.
• Naltrexone – is used in an intramuscular injectable form to treat opioid use disorder by blocking the euphoric and soothing effects of opioids such as heroin, morphine, and codeine. Unlike the other FDA-approved medications for opioid addiction, such as buprenorphine and methadone, naltrexone will not relieve withdrawal symptoms, but it also has no risk for misuse. It additionally has limited risk for drug-on-drug interaction, but individuals must usually wait a period after their last use of opioids to receive their first dose of naltrexone