How Medication Assisted Treatment Works

Those addicted to prescription painkillers like OxyContin are candidates for Medication Assisted Treatment.

According to the National Institute on Drug Abuse, in 2010 there were over 2.4 million people in the United States addicted to prescription medication alone. This figure does not take into account all of the people who are addicted to illegal drugs. To combat what is an addiction epidemic, doctors and scientists use a variety of methods, one of which is medication assisted treatment. To understand how this form or addiction treatment works it is important to know what it is, when to use it, who it is used on, what happens during treatment, and the benefits and consequences of this form of treatment.

What is medication assisted treatment?

Medication assisted treatment or MAT is a type of drug addiction treatment. It involves using a medication to manage addiction. According to the Substance Abuse and Mental Health Services Administration, medication when combined with counseling, behavior therapy, and other addiction treatments, works better than counseling and behavioral therapy alone. By combining treatments, a doctor or treatment center can treat the whole person rather than just one aspect of addiction. This improves the overall success rate and decreases the overall relapse rate of addiction treatment.

When is medication used?

Doctors use MAT to treat addiction in a variety of situations. The most common situations are:

• treatment of acute withdrawal,
• treatment when withdrawal might be permanently damaging,
• treatment when other conditions exist including chronic pain and mental disorders,
• treatment when counseling alone does not work.

Because many of the drugs used in MAT are addictive themselves, doctors are very careful about which drugs to use. Some of the medications they have to choose from are:

• Methadone,
• Suboxone and its other brands,
• Atenolol and other blood pressure medications,
• Klonopin and other anxiety relief medications, and
• Antidepressants.

Different medications treat different symptoms and addictions. The medication a doctor chooses depends on the individual patient. Not every patient is a candidate for MAT.

Who is a candidate?

Anyone who is addicted to a drug that is medically manageable with other medications is a candidate for MAT. It is up to a doctor to decide whether the side effects of a specific replacement medication are worth the benefits of treatment. People who are good candidates for MAT are those who are addicted to:

• prescription painkillers,
• heroin,
• opium,
• morphine,
• alcohol,
• stimulants,
• benzodiazepines,
• methadone, and
• cocaine,

Doctors may use MAT for other types of patients and usually evaluate these patients on a case by case basis.

What happens during treatment?

At the beginning of MAT doctors, evaluate a patient to find out which medication will work the best for their addiction. The doctor then prescribes the medication that best suits the addiction. When doctors are looking to replace an addictive drug like in the case of opiate replacement therapy, they start the patient on a high dose of medication to prevent withdrawal and cravings. After that, the dose is titrated down to a manageable level. Once management is achieved, some doctors will gradually reduce the medication in order to wean the patient off. This process may take weeks, months, or years depending on the condition, addiction, response to treatment, and many other factors.

The benefits

Doctors weigh the benefits and consequences of using MAT to help their patients get off drugs. There are many benefits to using MAT for addiction. A few of the most common benefits are:

• less incidents of relapse,
• ability to control the use of certain drugs such as opiates,
• reduction in incidents of Hep B, Hep C, and HIV infections associated with drug use,
• reduction in addict related overdoses,
• reduction in violent crime associated with drug addiction, and
• healthier drug related births.

These are not the only benefits associated with MAT. Most people who participate in MAT programs state that if forced to face all of the withdrawal symptoms that their drug of choice carries, they would not have attempted quitting. The fact that MAT reduces or stops acute withdrawal is a major benefit to those considering rehab.

The consequences

The drawbacks or consequences of MAT are more social issues than issues with the program. Many people start MAT and find out that it is not a perfect treatment or a catch all for addiction. It still requires a great deal of will power and the power to resist temptation depending on the circumstances of the addiction. The drawbacks of MAT are:

• MAT drugs are powerful and can cause addiction themselves. Although it is not swapping on addiction for another, the fact that the drugs that are used to help someone in recovery are often startlingly similar to the drugs they are addicted to is worthy of mention.
• Taking MAT drugs in combination with other legal and illegal substances can cause a ricocheted effect making both drugs dangerous.
• Some MAT drugs kill when combined with other legal drugs.
• The opportunity to abuse the MAT drugs exists. Some people join a MAT program to get the drugs. Then they sell the MAT drugs or trade them for other drugs.

Many doctors and psychologist point to the possibility of overdose on a MAT drug as a drawback. Research shows that although it is possible to overdose on MAT drugs, it is less likely than on illegal and uncontrolled substances.

Medication assistance treatment works by helping addicts with the withdrawal symptoms. Many people recover successfully because the lack of withdrawal symptoms allow them to continue their lives unencumbered. MAT is only one treatment option but when combined with a variety of treatments in a comprehensive treatment program it has been shown to help those with addiction stop using and avoid relapse.