Addiction is a chronic medical disease that can be treated as successfully as other chronic health conditions such as diabetes or hypertension.1 In many cases, medically assisted treatment may be necessary to help patients safely detox from addictive substances and overcome unpleasant withdrawal symptoms. They also may be beneficial in the prevention of relapse and overdose.2
What Is Medication-Assisted Treatment?
Medication-assisted treatment (MAT) is an approach to treating substance use disorders that employs medicines in combination with behavioral counseling and other forms of therapy.1
There is a list of medications used in MAT that are approved by the Federal Drug Administration (FDA).3 Which medication will be used and in which dosage depends on the severity of a particular case, whether it is used to treat heroin addiction or other substance abuse, and other case-specific factors. It is therefore vital that medication is used exactly as prescribed.2
Parallel with taking medication, patients undergoing medication-assisted treatment for substance abuse also need to work on changing their perceptions, attitudes, emotions, and behaviors. This helps them cope with triggers that may have prompted them to abuse substances. By developing these skills, patients become able to lead healthy lives without addiction. There are many forms of behavioral therapy that have proven to be effective in substance abuse treatment.4 The choice of behavioral treatment will also depend on the treatment needs of a particular patient and accessibility of treatment facilities.
Medically assisted treatment may be used to treat opioid use disorders, which includes both illicit opioid drugs and prescription drugs. Additionally, MAT may also be part of alcohol addiction treatment.
How Effective Is Medication-Assisted Treatment?
There are several confirmed positive effects of MAT, including:
- Decreased opiate use and improved chance of patient survival.1
- Prevention of opiate overdose-related deaths.5
- Lower risk of infectious diseases such as HIV or hepatitis C.1
- Less criminal activity.5
- Improved ability to gain and maintain employment.1
- Improved birth outcomes in pregnant patients with substance use disorders.5
In addition, patients tend to stay in treatment longer when medication is used in substance abuse treatment compared to treatment options in which there is no medication that can help them stabilize. When trying to quit using drugs, a great number of people may experience very unpleasant withdrawal symptoms, which they cannot cope with, so they go back to using drugs and quit treatment. If medication is used to help manage withdrawal, then patients can detox more successfully and focus on other elements of therapy that would eventually result in long-term recovery. 5
What Medications Are Used In Medication-Assisted Treatment?
Medications Used for Opioid Use Disorders
- Methadone is an opioid agonist, which means that it activates the same nervous system receptors as heroin. In contrast to illegal drugs, it is safer and it does not cause either the sensation of euphoria or sedation, so the person is able to function normally.6 It helps people go through withdrawal and reduces cravings for opioids.7 Patients take their daily dose of methadone orally in the form of tablets (Dolophine) or oral concentrate (Methadose), which can be obtained only through approved programs.8
- Buprenorphine is a partial opioid agonist, which means that it activates opioid receptors but to a lesser extent than illicit opioids or methadone. Unlike methadone, it can be prescribed by physicians and is, therefore, a more accessible form of treatment.9 It comes in the form of sublingual tablets (Subutex, Suboxone, Zubsolv), sublingual film (Cassipa, Suboxone), buccal film (Bunavail), injections (Sublocade), and subdermal implants (Probuphine).3
- To prevent abuse of this medication, some of its forms also include a substance called naloxone. Since there is a risk that opioid treatment medications may get abused, if someone tries to abuse buprenorphine and inject it, naloxone will cause unpleasant withdrawal symptoms. As a result, patients will abstain from abusing this medication.10
- Naltrexone is an opioid antagonist, which means that it blocks the effects of addictive substances on the receptors of the nervous system, which reduces cravings. Unlike methadone and buprenorphine, there is no potential for its abuse or diversion. It is given to the patient once a month in the form of a slow-acting intramuscular injection called Vivitrol.11
- Lofexidine is used in medically-assisted treatment for helping patients cope with unpleasant withdrawal symptoms. It is not used for long-term treatment but rather in a detox stage. It is used in the form of oral tablets called Lucemyra.12
Medications Used for Alcohol Use Disorders
- Acamprosate is used in medically assisted treatment of alcoholism to prevent relapse. It is not used in the stage of detox to mitigate withdrawal symptoms but is intended for people in recovery who are abstinent in order to maintain their abstinence.13 It comes in the form of oral tablets Campral.
- Disulfiram is used in medically assisted treatment of chronic alcoholism. It disrupts the metabolism of alcohol and discourages alcohol consumption because the patient experiences unpleasant effects when drinking alcohol.14 This medicine comes in the form of oral tablets Antabuse and is used once a day.
- Naltrexone is used in alcohol treatment for blocking the euphoric effects of alcohol, which results in reduced cravings and the amount of alcohol consumed. It helps patients stay sober after quitting alcohol. Treatment with this medication lasts for three to four months, during which period patients take one pill per day.11
Frequently Asked Questions
- The ultimate purpose of medication-assisted treatment is full recovery. As addiction is a treatable chronic disorder, the role of therapy is to stabilize the patient, improve their quality of life, and prevent relapse.2It is important to note that this kind of treatment does not substitute one addiction or drug for another less harmful one. Rather, the purpose of using medicines is to establish and maintain a biochemical balance that makes it possible for the patient to function normally.6
- Research evidence supports that MAT improves chances for long-term recovery.15 According to the principles of effective treatment established by the National Institute on Drug Abuse (NIDA), staying in treatment long enough is critical for success.16 Results of studies suggest that patients on medication-assisted treatment for at least one or two years have the highest chance for long-term recovery.17
- Medically assisted treatment is an individually tailored combination of medicines and behavioral therapy. There is no one-size-fits-all solution, so it is important that a trained treatment professional assesses the patient’s condition and prescribes optimal treatment options for that particular patient. Moreover, adjustments are made along the way as patients’ conditions and treatment needs change over time.16
- In addition to speaking to your healthcare provider, it is also possible to find treatment through Substance Abuse and Mental Health Service Administration’s treatment locators.18
1 .American Society of Addiction Medicine. (2019). ASAM Definition of Addiction.
2. Substance Abuse and Mental Health Service Administration. (2021). Medication-Assisted Treatment (MAT).
3. Food and Drug Administration. (2019). Information about Medication-Assisted Treatment (MAT).
4. National Institute on Drug Abuse (2018). Behavioral Therapies.
5. National Institute on Drug Abuse. (2016). Effective Treatments for Opioid Addiction.
6. Substance Abuse and Mental Health Service Administration. (2009). Know Your Rights: Rights for Individuals on Medication-Assisted Treatment.
7. Substance Abuse and Mental Health Service Administration. (2020). Methadone.
8. Psychiatric Research Institute. What Is Methadone?
9. Substance Abuse and Mental Health Service Administration. (2020). Buprenorphine.
10. National Institute on Drug Abuse. (2019). Naloxone.
11. Substance Abuse and Mental Health Service Administration. (2020). Naltrexone.
12. Medical News Today (2019). Lucemyra: Dosage, side effects, uses, and more.
13. Substance Abuse and Mental Health Service Administration. (2020). MAT Medications, Counseling, and Related Conditions.
14. Center for Substance Abuse Treatment. (2009). Incorporating Alcohol Pharmacotherapies Into Medical Practice. Treatment Improvement Protocol (TIP) Series, No. 49.
15. National Council for Behavioral Health. Medication Assisted Treatment.
16. National Institute on Drug Abuse (2018). Principles of Effective Treatment.
17. National Council for Behavioral Health. Challenging the Myths About Medication Assisted Treatment (MAT) for Opioid Use Disorder (OUD).
18. Substance Abuse and Mental Health Service Administration. Find Medication-Assisted Treatment (MAT).