Medication Assisted Treatment

Medication-assisted treatment (MAT) is an essential component of substance abuse treatment, especially for people battling opioid or alcohol addictions.

This type of treatment uses medications to help people come off opioids or alcohol safely and comfortably, lowering their risk of relapse and life-threatening overdose. 

Through gradual tapering, people can stay focused on their sobriety goals. Accompanying therapy and counseling helps improve overall mental health and well-being. 

About Medication Assisted Treatment (MAT)

Medication-assisted treatment is a type of substance abuse treatment that is most often used to treat opioid use disorders, and sometimes with alcohol use disorders as well. 

It involves administering medications on a regular basis to help ease the withdrawal symptoms of opioid or alcohol addiction, which helps people maintain sobriety and gain back their lives. 

MAT is also accompanied by various forms of counseling and therapy, so  people in this type of treatment can address their mental health or behavioral health as well. 

Note that MAT is meant to be a short-term treatment, though the length of duration can range from several weeks to several months, or even years if necessary. 

Key Facts on MAT for Addiction

• Conditions treated with MAT: opioid use disorder (OUD), alcohol use disorder (AUD)
• Medications used with MAT: methadone, buprenorphine, naloxone, naltrexone
• Side effects of MAT: constipation, fatigue, depression, weight gain, sleep disturbances, sexual problems, dizziness
• Benefits of MAT: lowers risk of overdose, lowers risk of relapse, considered a safe and evidence-based treatment, reduction of cravings and other withdrawal symptoms, improves effectiveness of other treatments, safer withdrawal period
• How to pay for MAT: self-pay/cash, private insurance, state-funded insurance, donations or grants

How Does Medication Assisted Treatment Work? 

Medication-assisted treatment uses medications to help people taper off opioids or alcohol slowly at a pace that is comfortable for them. 

The medications used are often a type of opioid. However, they work differently from other opioids. MAT medications do not get people high or cause the euphoric effect that makes other opioids and illicit opiates so addictive.

Instead, they either block the effects of all opioids or block the euphoric effects of opioids. These effects allow people to stop experiencing the addictive effects of the drug and taper off slowly while minimizing withdrawal symptoms. 

Types of Medications Used in MAT at Otter House Wellness

Medications used at Otter House Wellness in order to treat alcohol and opioid dependence include some of the most popular that are also FDA-approved. 

Suboxone (Buprenorphine/Naloxone)

Suboxone is one of the most common drugs for treating opioid use disorders, with both buprenorphine and naloxone being the active ingredients. 

Buprenorphine is an opioid partial agonist, meaning that it binds to opioid receptors and can cause euphoria in higher doses. However, it should not cause these effects when taken as prescribed for MAT. 

Because of this, buprenorphine treatment is considered a narcotic, requires a waiver to use, and any primary care physician prescribing it must hold a special DEA license.

Naloxone, on the other hand, is an opioid agonist, which means that it attaches to opioid receptors and blocks the effects of other opioids. 

Suboxone is given as a tablet or film, which is to be placed under the tongue and allowed to dissolve for 5 to 10 minutes. This is generally done once per day for people who have been prescribed Suboxone.

Sublocade (Buprenorphine Extended Release) 

This extended-release form of buprenorphine, sold under the brand name Sublocade, is a type of buprenorphine injection that only needs to be administered once a month. 

Taking buprenorphine in this form can help remove the burden of taking a daily medication and can be much more convenient for those looking to end their opioid or alcohol use. 

This type of buprenorphine should also only be taken after someone has already taken the oral form of the medication. 

Vivitrol (Naltrexone)

Naltrexone is a medication that is instead used in MAT for alcohol use disorders, but which can also be used in opioid treatment as well. 

It is an opioid antagonist, meaning that it blocks the effects of all opioids at opioid receptor sites. This medication can either be taken in pill or tablet form, taken once daily, or administered as an injection once a month. 

Note that naltrexone is not safe to use on a person who is currently using alcohol or opioids, and you may be drug tested prior to starting this medication to ensure its safety. 

In fact, it is recommended that people be sober from alcohol or opioids for at least 7 to 10 days before beginning a program with naltrexone. 

If it is taken before a person has stopped drinking or taking opioids, it can cause intense opioid withdrawal effects and increase a person’s risk of life-threatening overdose. 

Medication Assisted Treatment Programs

Medication-assisted treatment is an addiction treatment service that can commonly be found in all levels of care, including both inpatient and outpatient programs.

Many people start MAT during a residential program, and continue using MAT as an outpatient or aftercare service. 

MAT in Residential Programs

During a stay in a residential treatment center, MAT is likely to be administered on a daily basis or in the frequency and dosage required, as some MAT medications are only administered once per month. 

Depending on how long the person’s residential stay is, they may be done with MAT by the time they leave or they may continue MAT on an outpatient basis for as long as needed. 

MAT in Outpatient Programs

Outpatient programs for MAT will include medication at a frequency recommended by a mental health care provider, as well as outpatient therapy or counseling. 

For example, someone may attend therapy sessions once a week for counseling, and then once a month for medication. Or, they may receive a prescription they can pick up at their pharmacy, then administer daily on their own while attending weekly therapy. 

At Otter House Wellness, MAT is available in forms that are administered either daily or monthly and this will be factored into each individual’s treatment plan.

MAT in Aftercare Programs

MAT in aftercare programs is for people who have already completed an inpatient or outpatient treatment program, but still need medication for their long-term recovery needs. 

Because people are not meant to be on MAT forever, your physician will likely start working with you to taper off of MAT slowly during the aftercare process. This process involves gradually decreasing the dosage and frequency of your medication. 

People are never rushed to end their MAT, and some people remain using it for over a year after their treatment has ended. 

Types of Treatments Used with MAT

Medication-assisted treatment never means simply giving a person medication, as these medications are always given in combination with other services and therapies. 

In fact, under federal law, all certified Opioid Treatment Programs (OTPs) must provide treatment options including counseling and medical, vocational, and educational assistance services. 

Detox Services

Detoxification services are usually performed at the start of an inpatient or outpatient addiction program and are similar to MAT. But detox programs address short-term withdrawal symptoms at the start of the quitting process.

Without detox, people are more likely to relapse and overdose, especially with substances that can have life-threatening withdrawal symptoms like heroin and alcohol. 

In terms of treatment, detox and MAT can be administered at the same time, but in most cases detox is completed before MAT starts. 

Behavioral Therapy

Behavioral therapies are a type of psychotherapy that focus on the connection between a person’s thoughts and emotions and how they are related to their actions and behaviors. 

These types of therapy are used in addiction medicine because they address both negative behaviors, such as substance abuse, and negative thoughts and feelings that lead to those behaviors. 

Types of behavioral therapy include:

• Acceptance and commitment therapy (ACT) helps people by turning their focus on their negative thoughts and accepting them, rather than trying to avoid or ignore them which can in turn make their situation worse. 
• Cognitive behavioral therapy (CBT) helps people recognize their negative thought patterns and how they relate to their addiction, while learning healthy coping mechanisms and how to turn negative thought patterns into positive ones. 
• Dialectical behavior therapy (DBT) helps people to control their impulses, regulate their emotions, and develop healthier ways of dealing with stress and challenges than through using drugs or alcohol. 
• Exposure therapy helps people by gradually exposing them to their fears or triggers over a safe and comfortable period of time. This way they can adjust to fears within an environment that allows them to remain safe and supervised. 

Counseling

Counseling and individual therapy are incredibly important when participating in opioid addiction treatment to help address some of the underlying issues that have led to addiction. 

Without counseling to accompany medication-assisted treatment, people may continue to abuse substances or relapse without healthy coping mechanisms to help them through challenges. 

Benefits of Medication Assisted Treatment in Addiction Recovery

Medication-assisted treatment can often prove highly beneficial for keeping people in opioid treatment programs focused on their long-term recovery goals. 

Benefits of medication assisted treatment in addiction recovery include:

• Reduces uncomfortable withdrawal symptoms
• Helps stabilize and normalize brain chemistry
• Reduces cravings and lowers the risk of both relapse and alcohol poisoning or opioid overdose 
• Increases the overall survival rate for people with substance use disorders
• Increases the effectiveness and retention of other treatments
• Reduces the risk of infections like HIV and hepatitis C

MAT is not without risks, however. Anyone interested in this type of treatment should always discuss the pros and cons with their health care provider first. 

The MAT Debate

The use of MAT can be controversial in healthcare because it can be viewed as substituting one drug for another, as MAT drugs are also a form of opioid. 

While it is understandable why someone might have this belief, remember a couple things about MAT. First, people are not meant to be on MAT forever. 

People are only supposed to participate in MAT long enough to implement meaningful ways to cope with cravings and other symptoms that lead them to addiction. 

This will take different people different amounts of time, and for some MAT may be a long-term treatment, but no one is ever meant to be on it long-term. 

The second thing to note about MAT is that although these medications are opioids, they work very differently from addictive opioids which are considered habit-forming.

Finally, the opioids used in MAT are taken in a controlled and supervised environment, and with lowered doses over time. 

Hence, MAT is considered quite safe, and comes with much fewer risks than those involved with continuing to abuse drugs or alcohol.

MAT Treatment Timeline

The timeline for medication-assisted treatment can vary significantly depending on both the person and the specific drug they are using to help. 

For instance, someone with a severe opioid addiction may need to use MAT for a longer period of time than someone with a relatively new or mild opioid addiction. 

It is recommended that someone using MAT with methadone receive treatment for a minimum of 12 months, with the dosage gradually tapered during this time period, if possible. 

Other MAT drugs are recommended for a period of around a year or more as well, as research suggests that longer MAT programs are more supportive of long-term success. 

Some people may need to end their MAT sooner if they are experiencing negative side effects or if the drugs are interfering with another medical condition or medications. 

Cost of Medication Assisted Treatment

The cost of opioid treatment can depend on a few factors, including location, treatment duration, and the type of medication being used in treatment. 

The cost of MAT by drug type:

• Methadone: $126 per week/$6,552 per year
• Suboxone: $115 per week/$5,980 per year
• Naltrexone: $1,760.50 per month/ $14,112 per year

Keep in mind, these costs include not only the medication involved, but also the counseling, administration, and medical support services associated with MAT. 

Still, the costs of MAT can add up significantly over time, especially for people who are paying out-of-pocket for these services. 

These costs can also be at least partially covered by health insurance, including both private insurance and state-funded insurance like Medicaid and Medicare. 

The costs associated with MAT may also be lower if the MAT is part of a larger outpatient or inpatient program and included in the overall costs. 

Find Targeted Medication Assisted Treatment in North Carolina

Medication-assisted treatment of opioid use disorder or alcohol use disorder can be successful in addiction treatment where other methods have resulted in relapse. 

At Otter House Wellness, we offer medication-assisted treatment as part of our extensive outpatient programs available in partial hospitalization and intensive outpatient options. 

Your safety and comfort are always our top priority, and our compassionate and evidence-based programs are here to guide you toward lasting recovery and a better quality of life.