Medication-assisted treatment (MAT) is a commonly utilized treatment resource for those battling chemical dependency; it is specifically used to treat sufferers of opioid addiction and alcoholism. When integrated into a larger overall treatment plan, MAT can markedly improve patients’ long-term rates of abstinence and even help patients permanently cease alcohol and/or opioid use. The process involves utilizing specific FDA-approved medications to help patients reduce cravings and mitigate their withdrawal symptoms. The practice has become an increasingly relied-upon resource for treatment centers all over the country, and has shown promising success rates. Addiction and public health entities, including the National Institute on Drug Abuse (NIDA) and American Society of Addiction Medicine (ASAM), have endorsed MAT as a vital component of modern addiction care.
The intoxication that opioid or alcohol users feel is the product of neurotransmitters activated when these substance cross the brain-blood barrier. Repetition of this neurological activity can and often does cause the brain and central nervous system to develop tolerance and start to crave a regular and increasingly larger supply of these drugs. MAT drugs work by essentially acting as a substitute for opioids or alcohol and are administered over a longer period. Controlled supply of these drugs can satisfy the cravings while reducing withdrawal symptoms and making it easier over time to taper off.
Some of the more common types of MAT drugs include:
All medications used for MAT must be approved by the Substance Abuse and Mental Health Services Administration (SAMHSA). Eligibility for these medications will vary from patient to patient and must be approved by a licensed medical professional. MAT is also used sometimes used for smoking cessation therapy.
There are multiple studies that point to efficacy of MAT as a viable resource in opioid and alcohol treatment. Research reported by NIDA on long-term MAT for painkiller addiction care indicated that participants treated with buprenorphine reported an 11 percent increase in long-term abstinence over the course of three and a half years and fewer than 10 percent met diagnostic criteria for dependence on the drugs. ASAM and the Centers for Disease Control and Prevention (CDC) have both designated MAT as a vital tool in combating opioid addiction and subsequent overdose. Last year, in one of the first US-based studies sponsored by the NIDA, buprenorphine and naltrexone were found to be vital and effective clinical resources in helping patients achieve and maintain abstinence.
Each MAT patient’s duration of care is different. The primary goal is to gradually diminish cravings and withdrawal symptoms to the point at which patients can eventually achieve long-term abstinence without the use of the medications. This can take months or even years. Participants must work with a certified MAT practitioner who in turn must adhere to a series of established guidelines when implementing the treatment. Your prescribing physician will monitor your progress over a prolonged period and adjust your dosage accordingly. Those with longer histories of opioid or alcohol abuse will more than likely require longer periods of MAT.
Each prospective MAT participant must work with their doctor or treatment provider to assess their eligibility for the treatment. It’s also important to realize that each drug will have its own set of eligibility criteria.
For instance, SAMHSA recommends buprenorphine for patients who:
The best way to find out if you or a loved one is eligible for MAT is by speaking with a treatment provider or your primary care physician. Under current federal law, doctors are only allowed to prescribe Suboxone to 275 at a time, a cap recently raised from one-hundred patients.
Side effects of MAT will differ according to each patient’s substance use history and physiology. It is also possible for patients to develop actual withdrawal symptoms when on these medications for a sustained period. These symptoms will often mirror those of opioid withdrawal. Common MAT-related side effects include:
Talk to your prescribing physician about any of these symptoms, as they could lead to other, more serious health issues. More serious side effects can include chronic pain, shallow breathing, and even seizures or convulsions. It’s imperative that patients disclose all symptoms to their doctors to give a thorough idea of how their bodies are reacting to the medications.
There are multiple financial resources to help one more readily avail themselves of MAT once they’re approved. Admittedly, these medications are expensive (one injection of Vivitrol can cost about $850-$2000, depending on insurance), and more and more stakeholders are looking for ways to make MAT more affordable. For instance, the FDA just approved the first-ever generic form of Suboxone, which is expected to cost considerably less than its brand-name predecessor. Depending upon the laws of your current state of residence, Medicaid may also pay for all of your part of your MAT. You may also be eligible for MAT under your health insurance plan. The cost of each medication is different, so it’s important to speak with your physician and insurance company to find out your options.
SAMHSA describes MAT as most effective when administered in combination with counseling and rehab. Like any other singular treatment modality, MAT should be integrated into a larger overall treatment program. It should not supplant any other aspect of treatment, including behavioral therapy, medically supervised detox, and/or ongoing participation at AA or NA meetings. Addiction treatment is a matter of addressing both the physical and psychological elements of the disease. While stabilizing neurochemistry is critically important, such efforts must be accompanied by a thorough understanding of the root causes of substance abuse and what behavioral tools are available to avoid relapse.
Medication-assisted treatment is a proven and effective addiction care resource for eligible patients. More and more clinicians are embracing this therapy and exploring ways to make it more accessible to patients who might truly benefit from it. MAT offers the chance of a fresh start and the possibility of managing opioid or alcohol addiction each day while living life without the impending threat of relapse. Its progress in the pursuit of full and complete recovery has given thousands of patients the opportunity to work, function, and take care of their loved ones. If you or someone you care about is battling opioid or alcohol addiction, and you feel as though MAT might be an option, talk to one of our treatment specialists today.
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