Substance dependency issues continue to affect individuals around the globe. Here in the US, the opioid epidemic has become a severe public health crisis inflicting devastating and widespread damage. One of four hospital admissions in the US involves a substance abuse disorder. The misuse of opioids such as prescription pain relievers, heroin, and fentanyl cause an average of 128 overdose deaths every day. In response to this crisis, communities around the nation face an exponentially increasing demand for services to prevent and treat substance dependency.
Scientific inquiry has always played a vital role in developing solutions for deadly epidemics, and modern research into substance abuse disorders continues to prove particularly valuable. To confront the opioid epidemic and other substance dependence issues, behavioral health and substance dependency treatment centers currently focus on evidence-based practice, centered on the best available research. Currently, medication assisted treatment, or MAT therapy is one of the most-utilized practices for achieving safe, long-term recovery.
What Does MAT Stand for in Addiction Treatment?
Medication assisted treatment refers to the use of medication in combination with behavioral therapy and counseling to create an individually tailored, “whole patient” approach to substance abuse treatment. MAT assumes that substance dependency does not result from a single moral failing or one simple decision but from the integration of several constantly evolving, interrelated factors. Between 40% and 60% of patients experiencing substance abuse disorder require a dual diagnosis, meaning they also have an underlying mental health condition that must receive diagnosis and treatment along with substance dependency.
Therefore, effective clinical treatment depends on forming a comprehensive diagnosis that not only focuses on the substance abuse disorder but supports patient functioning in all aspects of daily life. Medication assisted therapy considers the various medical, social, financial, and psychiatric components involved in substance dependency. More importantly, MAT allows healthcare professionals to develop a strategic, personalized treatment plan for each patient to incorporate their goals and address their specific needs. While undergoing medication assisted therapy, patients must follow their treatment plan, agree to monitoring and assessment by a healthcare provider, and meet with a behavioral health professional on a consistent basis.
What Is the Main Goal of MAT?
The primary goal of MAT therapy is to help patients experiencing opioid, alcohol, or other substance abuse attain and sustain full recovery. As part of treatment, prescribed medication can normalize brain chemistry associated with substance abuse disorder, alleviate psychological cravings, block the euphoric side effects activated by misuse of the substance, and assist in returning the body to normal functioning.
Extensive research demonstrates medication assisted therapy can successfully treat substance dependency. Meanwhile, MAT can reduce the need for detoxification and other inpatient services, offering patients the ability to live an independent, healthy life after treatment.
What Drugs Are Used in MAT?
The US Federal Drug Administration (FDA) has approved several medications for safety, effectively treating opioid dependency involving morphine, codeine, heroin, oxycodone, and hydrocodone.
Buprenorphine often serves as the first choice for moderate to severe opioid dependency and can be used during detoxification or substance abuse treatment. This medication suppresses cravings and alleviates withdrawal symptoms but also provides negative reinforcement by causing patients to experience withdrawal symptoms if they stop taking it, encouraging treatment retention.
Buprenorphine also prevents patients from experiencing a high if they choose to abuse opioids during treatment, discouraging relapse. Buprenorphine induction may occur in an emergency department or other outpatient setting without requiring complete withdrawal first. Patients that continue abusing opioids while receiving buprenorphine should consider methadone as the next line of treatment.
Here at Illuminate Recovery, we use Sublocade (Buprenorphine/Naloxone) injections in our medication assisted treatment. We’ve found that these once-a-month injections help in preventing skipping and forgetting of doses. Also, we’ve found that it’s much easier to come off of once someone wants to stop taking Buprenorphine, due to the natural decline in the body that happens between injections.
Methadone is a suitable choice for patients struggling with moderate to severe opioid dependency who require intensive levels of support. Additionally, methadone is useful for patients experiencing severe chronic pain not well-managed by buprenorphine. This medication acts as a full agonist, mimicking the effects produced by opioids without creating a euphoric sensation. It blocks the effects produced by opioids, prevents withdrawal symptoms, hinders cravings, and allows the regions of the brain affected by opioids to regain a sense of normalcy.
Methadone offers slightly better outcomes than buprenorphine in terms of treatment retention but carries a higher risk of drug interactions and lethal overdose. It is only available from federally regulated opioid treatment clinics, which rarely exist in rural areas, and requires daily administration. Some patients receive treatment for a period of months, while others may need to continue taking methadone for the remainder of their lives to sustain recovery.
Naltrexone helps patients with mild opioid dependency, young patients with less than a year of substance abuse, and patients in residential treatment programs or prison who have already completed the withdrawal process. It may also be used as a third-line treatment option for patients with moderate to severe opioid dependency who experienced poor reactions to buprenorphine and methadone. Naltrexone demonstrates high rates of effectiveness in treating alcohol use disorder, so it is especially useful in patients with comorbid alcohol abuse and opioid dependency.
Unlike the options above, Naltrexone does not prove positive or negative reinforcement, so it functions best for patients who demonstrate a strong commitment to remaining in treatment. Patients must go through five to fourteen days of carefully monitored withdrawal before Naltrexone administration, making it ill-suited for outpatient programs. If a patient relapses after receiving naltrexone, the medication blocks them from experiencing the euphoric effects of the substance.
Is MAT Evidence Based?
MAT therapy is an evidence-based practice, meaning clinical decision-making and patient treatment plans are informed by empirically validated scientific methods like clinical trials, randomized controlled trials, and metanalyses. Substance dependency specialists implement evidence-based MAT by combining this scientific research with clinical expertise and carefully considering the specific characteristics, preferences, and cultural identity of each patient. Medication assisted therapy demonstrates high rates of success, even among individuals with long histories of chronic substance abuse. Experts regard MAT therapy as the gold standard of substance abuse care, especially when applied to patients with opioid use disorders.
One study evaluated the long-term outcomes of buprenorphine and naloxone treatment in combination with outpatient therapy. Researchers conducted follow-up interviews after 18 months of office-based treatment and found that 77% of participants who responded to the interview were still taking their medication. In addition, respondents taking these medications were significantly more likely to maintain abstinence, continue involvement in recovery programs, and hold steady employment. Another study that compared buprenorphine maintenance and methadone maintenance found that medium to high doses of buprenorphine are just as effective as retaining patients in treatment programs as methadone.
As a result, several health agencies endorse MAT therapy and recommend it as the first course of treatment for opioid dependency. The list includes the American Academy of Addiction Psychiatry, the American Association of Family Physicians, the American Medical Association, the Centers for Disease Control and Prevention, the National Institute on Alcohol Abuse and Alcoholism, The National Institute on Drug Abuse, the Office of the Surgeon General, the Substance Abuse and Mental Health Services Administration (SAMHSA), and the World Health Organization.
What Are the Benefits of Medication Assisted Treatment?
Extensive scientific evidence demonstrates that participation in medication assisted therapy leads to several benefits, including:
- Decreased use of opiates
- Increased treatment retention
- Reduced potential for relapse
- Lowered risk of overdose
- Increased probability of successful, long-term recovery
- Improved rates of survival by 50% or more
- Reduced costs of health care and substance abuse treatment
- Enhanced functioning
- Facilitated social integration
- Increased likelihood of gaining and maintaining employment
- Reduced tendencies to engage in criminal activities
- Advanced quality of life and ability to manage stress
- Lowered risk of contracting sexually transmitted diseases, including HIV and hepatitis C
- Improved birth outcomes in pregnant women with substance dependency
Are You Struggling with Substance Dependency?
If you are interested in benefiting from evidence-based medication assisted therapy, contact Illuminate Recovery today to learn more about our comprehensive MAT therapy program. We offer treatment throughout every stage of recovery, including detoxification, inpatient and outpatient care, individual and group therapy, sober housing, and relapse prevention services.
At our world-class facility, our team of experienced, licensed medical professionals will work directly with you to develop a personalized treatment plan that encompasses all your unique needs. We carefully examine the wide spectrum of issues that result in substance dependency, including diagnosing and treating underlying mental health disorders to provide you with the best chance of achieving a successful recovery.
For compassionate, dedicated medication assisted therapy, contact Illuminate Recovery today by calling (844) 700-9888 to discuss your recovery plan with a treatment advisor.
Having been on both sides of active addition, both the person using, and the person affected by a loved one using drugs and alcohol, Lucas has been involved in recovery since 2009. He has been working in the treatment industry since 2013. Using his personal experience and wealth of knowledge learned from professional development and immersion in the recovery field, he has spoken with thousands of families and helped hundreds of people attain long-term sobriety. In 2020, the opportunity presented to join in and start Illuminate Recovery. Understanding the importance of personalized treatment plans and the complex nature between substance abuse and co-occurring disorders, has helped Illuminate Recovery build a strong curriculum and a phenomenal staff. Illuminate Recovery now has a medical doctor who is board certified in addiction medicine and a psychiatric medical doctor who works side by side with independently licensed therapists to provide compassionate and effective treatment.