Recovery Made Possible
The Scope of Opiate Addiction
Medication-assisted treatment is one part of the recovery process when being treated for opiate addiction.
72,000 fatal drug overdoses took place in 2017.2
88,000 deaths annually are attributed to excessive alcohol use between 2006 and 2010.3
- Countries Who Lack Methadone Treatment 85% 85%
New research shows increasing medication-assisted treatment rates could prevent 6.1 million overdoses and save over 800,000 lives. In 85 percent of counties, there is not a single opioid treatment program where patients can access methadone. Forty-three percent of counties still do not have a clinician capable of prescribing buprenorphine.5
Why Medication-Assisted Treatment is Needed
The struggles of modern life are hurting many people all the time; many of these people will turn to alcohol and opioids for relief. Unfortunately, they find themselves stuck with dependence issues that can lead to full-blown addiction.
Large numbers of people with substance use disorders take steps towards treating opioid or alcohol dependence, but the journey back to a drug-free life is not an easy one. There are many obstacles like withdrawal symptoms, cravings, health risks, relapses, and a lot of related physical and emotional damage. As a result, the success rate for recovery is affected. However, with supportive treatments and helpful therapies, recovery is possible.
Medication-Assisted Treatment Explained
Medication-Assisted Treatment (MAT) programs are detoxification treatment processes that have been developed to address withdrawal and other symptoms related to detox. The goal of a medication-assisted treatment program is to provide a safer and less painful way to tackle detox from opioids or alcohol.
How Medication-Assisted Treatment Works
Medications that have some of the less harmful effects opioids or alcohol are given in controlled dosages over time. As they begin their recovery from addiction, patients avoid some of the painful withdrawal symptoms. Gradually, the medications are reduced so that the patient is substance-free. In this way, the patient gets a much better chance to remain sober during all stages of recovery.
Medication-assisted treatment programs are a combination of medications and therapy, along with a variety of treatments that ensure the best chances of recovering from addiction. Not only has it been known to save lives, but has also contributed to improved recovery rates.
Therapy in MAT
Therapy is an important component of medication-assisted treatment because it takes care of the psychological and emotional aspects of withdrawal symptoms associated with detox. Therapy gives the patient life skills that help sobriety. The basic idea is to replace negative emotions with a healthy, positive attitude towards life and its challenges.
Medication-assisted treatment programs are most effective with in-patient care, such as residential treatment programs. The patient remains at the MAT facility for the length of the program to get a lot of treatments ranging from detox to medication-assisted treatment, followed by post-treatment counseling.
Advantages of Medication-Assisted Treatment
Following a medication-assisted treatment program has quite a few benefits, according to the Substance Abuse and Mental Health Services Administrations (SAMHSA).
Foremost among its advantages is the improvement in patient survival rates. It has also been seen to help patients’ obtain employment and retain it.
Medication-assisted treatment has also been shown to help patients stay in treatment.
MAT is connected to a decrease in the illegal use of opiates as well as a reduction in criminal activities by people known to have substance use disorders.
MAT Medication Decoded
Depending upon the scope and purpose of treatment, the use of medications, approved by the U.S. Food and Drug Administration (USFDA), can vary from case to case in medication-assisted treatment. Some medications are expressly used for treating the withdrawal symptoms during the course of detoxification. Other medications are given to treat the addiction. These medications also give the patient the ability to become sober gradually.
Along with these medications, several other medications are also used to treat health conditions that are either pre-existing or are caused by withdrawal. Application of all these medications is made in a highly regulated manner to ensure the safety and well-being of the patient and ensure a successful recovery.
Medications Used for Opioid Addiction
Before looking at how medication-assisted treatment helps in alleviating opioid withdrawal symptoms, let’s broadly understand how opioids themselves affect the body. Opioids latch on to the opioid receptors in the brain, leading to pain reduction and a high. When substance abuse develops, opioids change the way the brain communicates.
The opioids produce too many mood-enhancing chemicals in the brain, hurting the brain’s ability to produce them naturally. Over time, a person no longer feels happy or normal without these drugs, leading to increased use. When used in medication-assisted treatment for opioid addiction treatment, medications block the typical effects of opioids or mimic their effects, but on a smaller scale and minus the euphoria.
Buprenorphine, a partial opioid agonist, is a medication that is used to treat opioid dependence and addiction. It has three qualities which are healthier than the effects of opioid drugs. These three qualities are responsible for the success of buprenorphine in treating opioid addiction withdrawal symptoms:
1. Instead of blocking the opioid effects, buprenorphine produces effects that are similar to them.
2. Buprenorphine doesn’t produce a sense of euphoria.
3. It also does not result in respiratory depression.
The first dose is given when withdrawal symptoms begin. The first dose is taken daily, then the dose and frequency are finetuned.
While buprenorphine has less of a chance to cause addiction when used under medical supervision, there is a risk of misuse by individuals who get the drug illegally.
For decades now, methadone has been a popular choice in the medical tool kit against opioid addiction. As is the case with other opioids, methadone alters the brain’s and the body’s responses to pain. But, methadone’s effects are considerably milder. This is used to reduce and control withdrawal symptoms during MAT for opioid detoxification.
Methadone’s effect begins slowly and gradually and stays in the body longer, keeping cravings at bay for as long as 36 hours.
There is a chance of addiction to methadone. But, the withdrawal and recovery are easier than other opioids.
Medications Used for Treating Alcohol Addiction
Easy availability has allowed alcohol to become one of the most abused substances in the entire world. For years, thousands of people have grappled with the problem of alcohol abuse, making it all the more difficult to treat alcohol dependence.
It is a well-known fact that withdrawal from alcohol addiction causes extreme withdrawal symptoms, including life-threatening conditions such as seizures. Medication-assisted treatment helps to eliminate or reduce these symptoms while the body is cleansed of toxins. Medication-assisted treatment makes getting sober safer.
Naltrexone blocks opioid receptors and significantly reduces cravings. It is used in the treatment of opioid as well as alcohol addictions. Naltrexone acts in a manner that is the same as the effects used in opioid detox. When naltrexone is administered, alcohol will not create a feeling of well-being. As a result, the patient is more likely to stop drinking.
In MAT, naltrexone is given in a tablet or an injectable form. This medication is taken in tablet form where the patient is prescribed a daily dose. In case of monthly dosages, it is available in injection form. The prescriber has to supervise the process for about a week or ten days.
Disulfiram is a highly popular medication for treating alcohol addiction because of the variety of unpleasant conditions it causes in people who consume alcohol while undergoing treatment. People who drink while under treatment with disulfiram are likely to suffer from conditions such as nausea, anxiety, vertigo, heart palpitations, vomiting, tachycardia, and other inconveniences.
While disulfiram can provide a very effective route to escaping alcohol dependence, the commitment to alcohol abstinence is vital on the part of the patient in MAT. If not, there is every possibility of a relapse and refusal to get treatment.
Acamprosate is a medication that is widely used to tackle alcohol cravings in people with a long history of alcohol use. Although much isn’t known about its inner workings, the drug induces a sense of calm and sedation by stimulating the brain’s gamma-aminobutyric acid receptors. The medication is believed to selectively affect certain brain receptors to create a reduced dependence on alcohol.
Acamprosate is generally administered in combination with one or more therapies and treatments. It is particularly used along with group therapy. While it is certainly an effective medication, acamprosate is most appropriate for patients who have already given up the drinking habit or are in the process of quitting.
Other Medications Used in MAT
Apart from the medications that are prescribed to help lessen withdrawal symptoms during medication-assisted treatment, it is common to administer other medications for addressing a variety of related and unrelated conditions such as pain, indigestion, mental health issues, and so on. Pre-existing issues are also considered, and necessary medications are factored in the treatment. All such medications are prescribed and administered with due care and under medical supervision to ensure a holistic treatment is provided for the patient to make a completely healthy recovery.
Therapies in Medication-Assisted Treatment
Apart from the use of certain medications, medication-assisted treatment also takes the help of various complementary therapies and counselling programs to provide a holistic treatment that assures complete treatment and withdrawal minus the attendant risks of withdrawal symptoms and possible relapse.
The therapies that are generally integrated into medication-assisted treatment range from cognitive-behavioral therapy (CBT), dialectical-behavioral therapy (DBT), and rational emotive behavior therapy (REBT) to individual and/or group therapy and extending up to mindfulness and stress management, family therapy, and even aftercare support. Alternative therapies like art therapy, yoga, outdoor therapy, and others can also be a part of the therapy regime.
All the programs are customized according to individual treatment needs. Counselors and clinicians work with clients to evaluate and find out their individual needs before treatment starts. Only then will the details of the individual medication-assisted treatment program, such as duration of treatment, medications to be prescribed and therapies to be included, are decided.
MAT Myths Busted
For those who are contemplating medication-assisted treatment, such myths and misconceptions can act as a depressant. It may even alter the patients’ attitude towards the treatment program and the doctors, leading to negative results from the treatment.
Myth: MAT Simply Supplants an Addiction with Another
Fact: It is a typical suspicion especially since drugs that are opioids or behave like opioids are used in medication-assisted treatment. While medications such as methadone and buprenorphine are administered, the fact remains that these are safer and longer-acting formulations that are administered in regulated dosages to protect the patient from possible substance dependence. Moreover, research in different quarters has shown that such medications are instrumental in maintaining patients’ health better, reducing criminal activities and drug-related diseases such as hepatitis and HIV.
Myth: Medication-Assisted Treatment is a Short-Term Solution
Fact: On the contrary, studies have shown that the highest rates of long-term success are observed in patients availing medication-assisted treatment programs that range between 1 to 2 years. Patients on long-term abstinence can aim to reduce dosages or totally stop usage by adopting a slow taper methodology under a physician’s supervision.
Myth: All Dependence Levels Do Not Warrant MAT
Fact: MAT is not a generalized treatment system with a ‘one-size-fits-all’ approach. Thanks to the variety of medication options such as antagonists, partial agonists and agonists that medication-assisted treatment relies upon, no level of dependence is too small or insignificant for the treatment system. Rest assured, MAT programs can be tailored for any level of severity of substance dependence or addiction.
Myth: MAT Raises Overdose Risks
Fact: Actually, medication-assisted treatment helps in preventing the occurrence of overdose, unintentional or otherwise. This is because after detoxification, the tolerance to opioid-induced euphoria is higher than that of respiratory depression. In such situations, sometimes even one single opioid dosage can turn out to be a fatal dose.
Myth: Medication-Assisted Treatment Can Hinder or Disrupt the Recovery Process
Fact: Over the years, MAT has been observed to have a positive effect on the patient’s resolve to stay away from substance usage and dependence. More importantly, medication-assisted treatment positively impacts patient mortality during the recovery process. By helping improve quality of life, stress-handling capabilities, and level of functioning, MAT speeds up a patient’s journey to recovery from addiction and dependence.
Do You Need Medication-Assisted Treatment?
With the wide array of medications and therapies available for addiction treatment, almost anyone with any degree of substance misuse or addiction can make use of MAT programs. Regardless of the time frame or the kind of substance dependence issues you are suffering from, you can be sure that a suitable MAT program is available to treat you or your loved ones.
Remember, MAT programs are designed around the concept of providing all that a person requires in the journey to normalcy while escaping the clutches of substance misuse or dependency. MAT programs are organized in peaceful campuses where privacy is protected and personal needs are taken care of with a human touch.
Locating MAT Services
To get medication-assisted treatment, you can contact one of your local Opioid Treatment Programs (OTP). However, make sure that the OTP has been accredited. This ensures that the MAT services you receive in such treatment centers are in fact proper, safe and legal.
To confirm if the OTP is certified, you can check out the information in the Opioid Treatment Program Directory.
According to federal law, patients enrolling in an OTP are entitled to receive a range of services in addition to the prescribed medication. These additional services include counseling, treatment services, and assessments pertaining to vocational and educational aspects. MAT professionals are also allowed to offer treatment and allied services in facilities ranging from hospitals and correctional facilities to office spaces and remote clinics.