What is Medication-Assisted Treatment (MAT)?
Medication-Assisted Treatment (MAT) combines the use of counseling and behavioral therapy along with FDA-approved medications to reduce the impact of substance use and help people stay in recovery. This evidence-supported practice helps improve the lives and wellbeing of patients, and is one of many pathways to long-term recovery.
The use of MAT has been shown to increase retention in treatment, decrease illicit substance use, and increase the patient's ability to gain and maintain employment. MAT has also been shown to lower the risk of contracting HIV and Hepatitis C by reducing the chance of relapse.
What Medications are Used?
A common myth surrounding MAT is that it is “just switching one drug for another.” This is in fact not true: MAT does not replace one substance for another. The medications and therapy used in MAT help to relieve the painful withdrawal symptoms and reduce the chemical imbalance that leads to cravings.
To date, three medications are approved by the FDA for the purposes of MAT:
Known as a Full Opioid Agonist, this medication binds to opioid receptors in the brain and causes a full response at those receptors. Methadone is a medication that allows for controlled tapering of usage, which aids in reducing harsh withdrawal symptoms and is compatible for extended use over time.
Methadone is also the primary approved form of MAT for pregnant or breastfeeding mothers.
Methadone can only be dispensed at a SAMHSA certified Opioid Treatment Program (OTP). Additionally, Methadone is taken once daily in one of its various forms including: tablets, liquid, powder, and diskettes.
For more information on Methadone visit: https://www.samhsa.gov/medication-assisted-treatment/treatment/methadone
Known as a Partial Opioid Agonist, this medication produces similar effects to illicit opioids but has a “ceiling effect” where after a certain dose, the effects are inhibited. This ceiling effect lowers the risk of misuse, dependency, and other side effects such as respiratory depression or death.
Burenorphine can be prescribed by U.S. physicians and mid-level practitioners within physician offices, community hospitals, health departments, or correctional facilities once a provider has obtained the proper prescribing waiver for this medication.
For more information on Buprenorphine visit: https://www.samhsa.gov/medication-assisted-treatment/treatment/buprenorphine
Known as a Full Opioid Antagonist, this medication binds fully to the opioid receptor sites in the brain but blocks the opioid receptors from engaging with another opioid. This stops the addictive high and reduces opioid cravings.
Because Naltrexone is a full opioid antagonist, patients should not use opioids 7-10 days before starting this medication. Naltrexone is available in a pill form (taken once daily) or an injectable form (taken once monthly).
For more information on Naltrexone visit: https://www.samhsa.gov/medication-assisted-treatment/treatment/naltrexone
Is MAT for Everyone?
Medication-Assisted Treatment is designated to treat opioid use, but there are always precautions that can be taken for certain populations to ensure the best outcomes for health, wellness, and recovery.
Methadone is not advised or permitted in most cases for patients under the age of 18 years old.
Burenorphine is approved for the use of patients as young as 16 years old by the FDA.
Naltrexone may also be used.
Making Adjustments for Other Medications
When beginning MAT, be sure to talk to your primary health providers about any additional medications you may be taking at that time. Medications such as benzodiazepines and gabapentin are the two examples of medications that may require modified dosages while using MAT.
Medication-Assisted Treatment (MAT) is an evidence-based method of helping people who are experiencing Opioid Use Disorder find long-term recovery and wellness.