What is Medication-Assisted Treatment?
According to the Substance Abuse and Mental Health Services Administration (SAMSHA), Medication-assisted treatment (MAT), “including opioid treatment programs (OTPs), combines behavioral therapy and medications to treat substance use disorders.”
For more on MAT, see Medication Assisted Treatment Guide: Opioid Use Recovery Can Become Long-Term
Medicated-Assisted Treatment (MAT) employs a “whole-patient” approach to substance use disorder treatment, combining counseling and behavioral therapies with FDA-approved medications.
Medication-Assisted Treatment for Opioid Addiction
Three medications to treat opioid addiction are methadone, buprenorphine, and naltrexone. They are used to “treat opioid dependence and addiction to short-acting opioids such as heroin, morphine, and codeine, as well as semi-synthetic opioids like oxycodone and hydrocodone.” Of course, in certain cases, individuals can MAT medications safely for extended periods of time. Here’s how SAMHSA describes each drug:
- Methadone: “Methadone tricks the brain into thinking it’s still getting the abused drug. In fact, the person is not getting high from it and feels normal, so withdrawal doesn’t occur. Learn more about methadone.”
- Buprenorphine: “Like methadone, buprenorphine suppresses and reduces cravings for the abused drug. It can come in a pill form or sublingual tablet that is placed under the tongue. Learn more about buprenorphine.”
- Naltrexone: “Naltrexone works differently than methadone and buprenorphine in the treatment of opioid dependency. If a person using naltrexone relapses and uses the abused drug, naltrexone blocks the euphoric and sedative effects of the abused drug and prevents feelings of euphoria. Learn more about naltrexone.”
Medication-Assisted Treatment for Alcohol Use Disorder
According to SAMHSA: “Disulfiram, acamprosate, and naltrexone are the most common drugs used to treat alcohol use disorder. None of these drugs provide a cure for the disorder, but they are most effective in people who participate in a MAT program.” The medications that SAMHSA notes include:
- Disulfiram: “Disulfiram is a medication that treats chronic alcoholism. It is most effective in people who have already gone through detoxification or are in the initial stage of abstinence. This drug is offered in a tablet form and is taken once a day. Disulfiram should never be taken while intoxicated and it should not be taken for at least 12 hours after drinking alcohol.”
- Acamprosate: “Acamprosate is a medication for people in recovery who have already stopped drinking alcohol and want to avoid drinking. It works to prevent people from drinking alcohol, but it does not prevent withdrawal symptoms after people drink alcohol. It has not been shown to work in people who continue drinking alcohol, consume illicit drugs, and/or engage in prescription drug misuse and abuse. The use of acamprosate typically begins on the fifth day of abstinence, reaching full effectiveness in five to eight days.”
- Naltrexone: “When used as a treatment for alcohol dependency, naltrexone blocks the euphoric effects and feelings of intoxication. This allows people with alcohol addiction to reduce their drinking behaviors enough to remain motivated to stay in treatment, avoid relapses, and take medications.”
Misconceptions in Medication-Assisted Treatment
SAMHSA notes several misconceptions about MAT, including the idea that all it does is swap one drug for another.
The agency writes: “Instead, these medications relieve the withdrawal symptoms and psychological cravings that cause chemical imbalances in the body. MAT programs provide a safe and controlled level of medication to overcome the use of an abused opioid. And research has shown that when provided at the proper dose, medications used in MAT have no adverse effects on a person’s intelligence, mental capability, physical functioning, or employability.
“Medications used in MAT for opioid treatment can only be dispensed through a SAMHSA-certified OTP. Some of the medications used in MAT are controlled substances due to their potential for misuse. Drugs, substances, and certain chemicals used to make drugs are classified by the Drug Enforcement Administration (DEA) into five distinct categories, or schedules, depending upon a drug’s acceptable medical use and potential for misuse.”
Gender Differences in Drug Addiction
To think about Medication-Assisted Treatment, it may help to understand gender differences in drug addiction.
Men and women are very different when it comes to addiction and treatment for addiction. Research is often geared at gender differences when it comes to drug abuse and addiction.
The National Institutes of Health reports: “Men are more likely than women to use almost all types of illicit drugs, and illicit drug use is more likely to result in emergency department visits or overdose deaths for men than for women. ‘Illicit’ refers to use of illegal drugs, including marijuana (according to federal law) and misuse of prescription drugs. For most age groups, men have higher rates of use or dependence on illicit drugs and alcohol than do women. However, women are just as likely as men to develop a substance use disorder. In addition, women may be more susceptible to craving and relapse, which are key phases of the addiction cycle.
Some recent statistics from the Substance Abuse and Mental Health Services Administration, the Centers for Disease Control and Prevention and The National Institute on Drug Abuse point out some interesting facts about men and addiction. These key facts are listed below:
- Men are four times more likely than women to be heavy drinkers and two times as likely to be dependent upon alcohol.
- About 5 million men report past-year misuse of drugs or alcohol.
- Men are more likely to develop an addiction disorder and abuse more than one substance.
- Most often, men begin using substances at an earlier age, and use them more often.
- Men are 2.3 times more likely than women to enter treatment for their addiction, however, many men enter via the criminal justice system.
- Men are more likely to struggle with pride and denial as well as relapse triggers such as depression and anxiety during addiction recovery.
- Interestingly, more than half of men who struggle with addiction also have another mental illness, including depression, bipolar disorder and PSTD.
- Men are almost 4 times more likely to commit suicide while drinking.
- Men are nine times more likely to die of an alcohol-associated heart disease.
- Men are more at risk than women to drink alcohol excessively and are therefore more likely to take other risks (for example: reckless driving, or driving without a seat belt). These risks further increase the possibility of injury or death.
When considering MAT, one might want to consider this NIH note: “Research has shown that women often use drugs differently, respond to drugs differently, and can have unique obstacles to effective treatment as simple as not being able to find child care or being prescribed treatment that has not been adequately tested on women.”