Medication-Assisted Treatment (MAT)
A widespread crisis of substance use disorders has consumed the United States, particularly an opioid epidemic. The news continually covers stories about drug-related deaths across the country. The epidemic of addiction is primarily fueled by the over-prescription of opioid painkillers, such as Vicodin and Percocet. The drug itself is in the opiate category, a class of dominant pain relievers derived from opium, which includes heroin and morphine. Opioids are synthetic formulations of the same drug, such as Oxycontin and Norco.
When people take these medications for legitimate purposes, it doesn’t take long to develop an addiction to them. When access to medicine runs out, people may turn to illegal means to obtain more. The particularly insidious aspect of opioid and opioid use disorder is that users quickly build a tolerance to the drugs, requiring increasingly greater amounts to get the same high they felt in the beginning. Once they have developed a tolerance to the drug, the opioid withdrawal symptoms from lack of use become much more severe, leading to a possible opioid overdose.
Helping people beat their addictions to opioid drugs is a matter of life and death. These addictions aren’t just disruptive issues in a person’s life. Addiction to opioids can often lead to crimes, overdoses, and even death. Treating opioid dependence can require a different rehabilitation approach as compared to other substances.
Based on the ASAM National Practice Guideline and the Society of Addiction Medicine, medication-assisted treatment for opioid use disorder usually works better than complete abstinence from opioids as relapse prevention. In combination with behavioral therapies, medication-assisted treatment with FDA-approved medications has a high success rate. Some of the MAT medications used include:
Methadone is perhaps the best-known medication in substance abuse treatment for weaning off active opioid addiction. It was initially developed in the 1940s to suppress coughing. It’s true that methadone is itself a synthetic form of opiates.
However, methadone maintenance treatment is effectively used for treating opioid addiction because the action is much weaker. It binds to the same receptor cells, satisfying the body’s craving for opioids and preventing withdrawals. Because it attaches to those cells, it also means that using opiates will not produce the “high” that the user seeks. It is available in pills or in liquid form.
Buprenorphine is another synthetic opioid used for withdrawal symptoms. It was first developed in 2002 and released under the names Suboxone or Subutex. More recently, the FDA has approved other forms of the same drug specifically for use in medication-assisted therapy. It is also available in a monthly injectable form, making compliance easier in more severe addictions.
Buprenorphine is a partial opiate agonist, which means it both blocks opioid cravings and the effects. When people with opioid addictions try to take drugs while using buprenorphine, they won’t obtain the same high that they want.
Naloxone is another synthetic drug that can be used to block the effects of opioids. It is most popularly used in emergencies to treat overdoses because it fights against the opiate receptors in the brain. When used in this way, it can reverse the effects of an overdose and block euphoric effects. It is also used in managing addiction with patients who are at a significant risk of overdose. It is available in a patch, table, injection, or a combination formulation.
Naltrexone helps to treat alcohol use disorder withdrawal symptoms. However, it can also be used in treating opioid dependence by blocking the cravings and desire for the substance. This medication is often given as an extended-release injectable suspension. Naltrexone bars the opiate receptors as an opioid antagonist and increases the production of dopamine, making the user need less of a high.
Why Medication-Assisted Treatment is Successful in Opioid Use Disorders
Studies on opioid use disorder show that medication-assisted treatment (MAT) is incredibly helpful in helping opioid-addicted patients avoid getting high and in reducing risk behaviors. It can also be useful in weaning off opioids entirely and does not have to be used long-term.
A study at the University of Texas Health Science Center at San Antonio School of Medicine researched the use of MAT in treating opioid use disorders. In the study, 653 people received consistent sublingual buprenorphine treatment for two weeks. During the following two weeks, they were tapered off the drug.
Those who fell back into using opioid pain relievers during the two months after the start of the program received buprenorphine for 12 weeks, followed by four weeks of tapering from the drug.
After 42 months of the program, 300 participants were interviewed about their opioid use disorder. More than 61 percent said they had been drug-free for at least 30 days and 92.5 percent said they were not reliant on any pain-relief substances.
How Medication-Assisted Treatment is Used in Recovery
Abstinence-based treatment programs have long been used in addiction medicine to treat substance use disorders for those seeking care for opioid addiction. However, not everyone responds the same way to one single treatment of opioid dependence.
Using opioid replacement treatments, including the use of methadone or buprenorphine injections, can be an essential and powerful adjunct to outpatient rehab programs and other mental health services. These treatments work to reduce withdrawal symptoms, chemical imbalances, and psychological cravings.
Using medication assisted treatment in recovery must be used on the right candidates. Not everyone is a good choice for this type of step-down approach to healing. Some important criteria for consideration in using MAT include the following:
- Are fully detoxed from and not dependent on other non-opioid substances such as alcohol and benzodiazepine medications, such as Xanax or Klonopin.
- Can participate in an initial intake session with healthcare providers, which usually lasts approximately three days.
- Mood instability issues have been treated successfully (likely with behavioral therapy or psychosocial therapy), and the individual has no thoughts of suicide.
- Understand and agree to the program’s requirements of no other drug use.
- Reside in Florida or close enough to commute to the treatment center.
- Complete forms consenting to treatment and an opioid replacement therapy participation contract.
Opioid addiction is a grave matter in the substance abuse realm. It can be challenging to get clean and stay clean without proper addiction treatment. In many cases, opioid use disorders need to be treated differently than other addictions such as alcohol use disorder. Using medication-assisted therapy with a certified opioid treatment program can be a very effective way to step down from active addiction, especially when combined with supportive psychotherapy, 12-step meetings, and other mental health services.
If you or someone you love is struggling with an addiction involving opioid use, know that there is hope for the future. If you would like to learn more about these programs and treatment options, including monthly buprenorphine injections, call the specialists at our treatment center today. Help is closer than you think and more attainable than you might have imagined. A healthy, sober, substance abuse free future is within your reach.