Medication-Assisted Treatment (MAT): Everything You Need to Know

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The hands of a doctor and patient reviewing medical paperwork and discussing medication assisted treatment

Medication-Assisted Treatment (MAT) is a treatment option that uses prescription drugs to help support your addiction recovery. Although there is no “cure” for alcoholism or opioid addiction, these types of medications can aid in leveling out brain chemistry and relieving intense drug cravings.

When you first quit using substances, you will likely experience serious, acute withdrawal symptoms such as nausea, vomiting, diarrhea, tremors, muscle aches, and seizures. If you choose to detox under medical supervision, these symptoms can be treated with Medication-Assisted Detox (MAD) to stabilize your physical health.

Once the sharp, physical withdrawal symptoms subside, you may still experience less severe, more psychological, and emotional symptoms, often grouped together under post-acute withdrawal syndrome (PAWS). These can include intense mood swings, insomnia, trouble concentrating, and cravings. Depending on the person, these specific symptoms can last for a few weeks or several months and cause a high risk of relapse. There are different ways to tackle these conditions including a range of prescription MAT drugs that target the reduction of cravings.

Read below to find out more about the functions of each medication:

Medications Offered During Medication-Assisted Treatment

Determining whether or not MAT treatment is right for you depends on multiple factors like drug use history, overall health, and your own preferences. If you need help, speak with a medical professional to learn about which MAT medications would work best for you.

Buprenorphine

Buprenorphine is a partial opioid agonist. It attaches to and activates the opioid receptors in the brain just like full opioid agonists such as heroin, fentanyl, and prescription painkillers, but buprenorphine gives only a partial, much less dramatic effect. There is a “ceiling effect” with buprenorphine whereby reactions level off even if doses increase. Because this medication does not create euphoria, there is less risk of misuse, dependency, and overdose, making buprenorphine an effective way to reduce opioid cravings.

Buprenorphine is available under the brand names Subutex, Suboxone, and Sublocade.

  • Subutex contains buprenorphine as the active ingredient. This medication is taken sublingually under the tongue once a day. There is a higher potential for abuse with Subutex.
  • Suboxone is a combination of buprenorphine and naloxone which is available as pills or filmstrips. Naloxone is an opioid antagonist, which binds and blocks opioid receptors, and is added to prevent misuse.
  • Sublocade is an injection containing buprenorphine taken once a month and administered subcutaneously (under the skin) into the abdomen. Doing so, allows the buprenorphine to slowly and safely be released into the bloodstream.

Methadone

Methadone is known as a full opioid agonist, which means it attaches to and activates opioid receptors in the brain to cause an opioid effect similar to heroin and fentanyl. However, the key difference between methadone and other opioids is that methadone releases slowly in your body to avoid any euphoric rush and reduce cravings. As a long-acting opioid, this drug remains stored in bodily tissues where it can be gradually released into the bloodstream throughout the day.

Methadone is available in a variety of formulations, including liquid, pill, and diskette forms. Most methadone maintenance programs require you to receive treatment in a clinic until you reach a stable point, and then you can continue taking the medication at home. Dosage is determined by a medical professional and is usually taken for at least a year in recovery. Because methadone is an opioid, there is a risk of relapse and overdose. Methadone should be used under close medical supervision and taken only as prescribed by your physician.

Disulfiram

Disulfiram is an alcohol sensitizing agent sold under the brand name Antabuse normally taken once a day in pill form. This medication limits the risk of relapse and deters you from drinking altogether. By interfering with the alcohol breakdown process in your liver, disulfiram creates an upsurge of acetaldehyde, which is toxic to the body and leads to unpleasant side effects. When you drink even a small amount of alcohol while taking disulfiram, you will experience an adverse reaction. This can include sweating, anxiety, trouble breathing, weakness, blurry vision, headaches, itching, and nausea.

Acamprosate

Acamprosate, also sold under the brand name Campral, is a medication that supports the treatment of alcohol use disorder. When you drink, alcohol decreases the excitatory neurotransmitter glutamate, causing a sedative effect. After quitting alcohol, your nervous system becomes hyperactive with an abundance of glutamate, and you may crave alcohol again to calm down. Acamprosate works to restore brain chemical balance by increasing GABA levels in the brain which is a neurotransmitter that produces a calming effect on your body by blocking messages sent between nerve cells in your brain.

This drug decreases alcohol cravings but does not help with symptoms of alcohol withdrawal. Acamprosate is available as an oral tablet that is usually taken three times daily but depends based on the user. Some studies have shown that the combined use of acamprosate with naltrexone may produce better results for long-term alcohol abstinence than the use of any single medication alone.

Naltrexone

Naltrexone is an opioid antagonist that binds and blocks opioid receptors, rather than activating them. Naltrexone helps treat both alcohol and opioid addiction by suppressing substance cravings. If you attempt to circumvent this blockage with large doses of opioids, you may die or suffer from serious side effects, including coma. Some of the advantages to this medication are that it is not addictive and does not produce a high nor cause withdrawal symptoms after you stop using it.

Naltrexone is sold in pill form and also under the brand name Vivitrol as an extended-release injectable. Because Vivitrol only needs to be administered once a month, it provides you the opportunity to receive treatment on a flexible schedule. It is also a great option if you tend to forget to take your medications, or if you are currently on a methadone or buprenorphine regimen and would like to switch to a non-opioid alternative. Keep in mind that you must be opioid-free for 7-14 days before taking any form of naltrexone.

The Main Takeaways

While current medications only address opioid and alcohol addiction, clinical trials are currently showing promising signs that treatment for methamphetamine addiction is on the horizon.

The dosage of each addiction medication and length of MAT treatment varies from person to person. It is important that you remember to take these medications directly as prescribed by a medical professional. If you happen to experience a recurrence while you are on MAT treatment, you can experience serious side effects such as loss of consciousness, difficulty breathing, coma, overdose, or even death. Seek medical help immediately.

While cravings may subside with MAT, these medications do not address all factors that contribute to substance abuse. Comprehensive treatment is strongly recommended in conjunction with Medication-Assisted Treatment so you can address underlying mental health issues and develop more adaptive coping skills. This is the most effective way to fight addiction and achieve longer-lasting recovery.

If you or a loved one is struggling with addiction, Mountainside can help.
Click here or call (888) 833-4676 to speak with one of our addiction treatment experts.