The most basic definition of medication-assisted treatment (MAT) is the use of medications in addiction treatment in combination with behavioral therapy and counseling. It is most commonly used to treat those dependent on opioids such as prescription painkillers or heroin, but it can also be used in the treatment of substances such as alcohol or benzodiazepines, which can have dangerous withdrawal symptoms.
MAT during addiction recovery remains a controversial subject, as many people are concerned that when it is used, someone is just replacing one addiction with another, especially in the case of treating opioid withdrawal through the use of other, weaker opioids like methadone.
However, this is a significant misconception, as the medications being given to those in treatment are not harmful, especially in comparison to whatever substance they had become dependent on. Another key distinction is that medical professionals closely monitor the administration and dosage of these medications.
This does not mean, however, that everyone who enters addiction treatment is going to be prescribed medication during the process. No single form of addiction treatment is going to be equally effective for everyone, and that includes medication-assisted treatment. So what determines whether a rehab center will prescribe medication, and what is it used for?
The medications that are commonly administered during MAT therapy have different purposes, including helping to block the euphoric effects of alcohol and other drugs, adjust someone’s brain chemistry to how it was before they began engaging in substance abuse and also to normalize body functions that were also adversely affected by addiction.
When it specifically comes to detox, the idea of using drugs during a period in which someone is supposed to be removing them from their body can admittedly sound counterintuitive. However, as previously mentioned, medication can be extremely useful during detox, especially when it comes to managing withdrawal symptoms, which can be extremely unpredictable depending on the substance, the severity of the addiction, and whether or not a co-occurring disorder is also present.
The U.S. Food and Drug Administration (FDA) has approved a variety of medications for therapeutic purposes that can be used during medical detox.
Detox medications are frequently employed to help those in withdrawal address unpleasant withdrawal symptoms that commonly occur such as:
MAT may also be utilized during medical maintenance therapy, which is part of the process of slowly weaning someone off a substance they are dependent on and gradually reducing the dosage until it is safe to stop using. This is called a tapering schedule, and it is necessary for drugs that are dangerous to immediately quit all at once.
Central nervous system (CNS) depressants like benzodiazepines and alcohol, in particular, can trigger an intense shock to the body when stopped abruptly after chronic abuse, which can lead to potentially life-threatening symptoms such as:
In these cases, it is crucial that the dosage of the substance that someone has become dependent on is slowly lowered, and they are weaned off it. Medication used in medical maintenance therapy can help subdue drug cravings and make the tapering process less of an ordeal.
For opioid detox treatment, the goal is still sobriety, but this may be done a bit differently through the use of weaker opioids such as methadone and buprenorphine. These are often employed to help ease withdrawal symptoms and wean someone off the opioid they are addicted to in a way that is safe and less likely to result in relapse, with the eventual goal being abstinence.
As previously stated, addiction treatment is not a “one-size-fits-all” situation. One of the major cornerstones of effective addiction treatment is that it’s tailored to a person’s individual needs. Addiction is complicated, and so no two treatment approaches are exactly alike. What works for one person may not for another, and this is also the case for medication-assisted treatment.
Assuming that the treatment center offers MAT, as not every program will, some of the factors that go into the evaluation and determination of whether or not someone would benefit from being prescribed medication during addiction treatment include:
While some of these factors will be examined during someone’s initial evaluation before detox and beginning their treatment, much of it will also be part of the construction of someone’s treatment plan with their clinician for what will be most effective in working toward a successful recovery.
One of the most crucial things to remember about medication-assisted treatment, though, is that it is just that, assisted, as opposed to medication as treatment. While medications like Suboxone can prove invaluable in helping someone stabilize and remove themselves from the cycle of substance abuse, medication alone is not going to be enough to make for a successful recovery from addiction.
For treatment to be effective, it needs to address multiple needs as well. That means it’s usually not enough to put someone on medication to help them avoid withdrawal symptoms and then send them on their way.
If a rehab center does prescribe someone medication during treatment, it needs to be combined with counseling and behavioral therapies that can help them get to the root of the issues behind their addiction. It should also address underlying problems and help people learn to cope with stress in a positive way that can boost someone’s chances of recovery and maintaining long-term sobriety.
National Institute on Drug Abuse. (2018, January). Pharmacotherapies. from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment/evidence-based-approaches-to-drug-addiction-treatment/pharmacotherapies
U.S. National Library of Medicine. (2016, April 20). Opiate and Opioid Withdrawal. from https://medlineplus.gov/ency/article/000949.htm