Medication-Assisted Treatment

Addiction treatment has come a long way when you consider that it was only recently deemed a disease. A relatively newer form of therapy, known as medication-assisted treatment (MAT), is a highly sought out method being implemented in a drug and alcohol rehab environment. Unfortunately, despite its success, it has been met with resistance because of its unorthodox approach. Medication-assisted treatment is similar to fighting fire with fire, but using these medications to treat alcohol or opioid addiction has shown great promise. Opioid addiction is considered one of the worst public health crises of our time, with no signs of slowing.

The National Institute on Drug Abuse (NIDA) released data showing that 128 people die each day due to opioid overdose in the United States. The unfortunate statistic includes a combination of heroin, prescription opioids, and fentanyl. We have watched this trend increase each year steadily, and researchers continue to work tirelessly to seek solutions that treat this public health crisis.

More than 47,000 American’s lost their lives because of an opioid overdose in 2017. During that same span, an estimated 1.7 million people struggled with substance use disorders directly linked to prescription opioid painkillers. In addition to those numbers, an estimated 652,000 people struggled with heroin addiction.

An estimated 21 to 29 percent of those who use opioids for chronic pain will misuse them, and another eight to 12 percent will develop an opioid use disorder (OUD). Despite the setbacks we’ve faced as a country, it’s pushed organizations like the U.S. Department of Health and Human Services (HHS) to develop five major priorities for the battle against opioids. These five priorities include:

  1. Improve access to treatment and recovery services – time is of the essence when it comes to addiction treatment.
  2. Promote the use of overdose-reversing drugs like Narcan.
  3. Educate the public about the epidemic with better public health surveillance.
  4. Offer support for cutting-edge research on addiction pain.
  5. Continue the advancement of better practices to deal with pain management.

Since these initiatives were put through by HHS, it has led to the necessity of modernized solutions to treat addiction, such as MAT. Below we’ll delve into medication-assisted treatment and how it could benefit someone struggling with addiction.

What Is Medication-Assisted Treatment?

Medication-assisted treatment (MAT) uses specific medications to treat addiction in conjunction with behavioral therapies and counseling. The purpose is to provide a “whole-patient” approach while treating substance use disorders. 

MAT is most often used to treat opioid addiction, such as prescription pain relievers or heroin, but it can also be used for recovering alcohol users. MATs purpose is to normalize brain chemistry, relieve psychological cravings, normalize body functions, and in the case of opioids, block the euphoric effects associated with use. It does all this without the adverse effects of the abused drug.

The medications used in medication-assisted treatment have all been approved by the U.S. Food and Drug Administration (FDA). Each program is tailored around the specific needs of the client. Unfortunately, combining these drugs with anxiety medications can be fatal. These include benzodiazepines like Valium or Xanax. You must always follow the doctor’s medical plan and never use anything outside their treatment scope.

What Drugs are Approved?

Opioids

As of now, only three drugs approved to treat opioid dependence. These include:

  • Methadone
  • Naltrexone
  • Buprenorphine

These medications have gone through rigorous testing and are proven to be effective – they are also promoted for their safety. If someone is seeking treatment for an opioid use disorder should be given access to these options without limitations. Opioid addiction is chronic by nature, and physicians must continually re-evaluate the client to determine whether they need to continue MAT. There is not a maximum recommended duration for this treatment option for now, and some clients may be placed on a medication regimen for an undetermined period. 

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Alcohol

Alcohol use is the third leading cause of preventable death in the United States, and for those struggling with a severe alcohol use disorder (AUD), clinicians may provide medication to help in their battle. These FDA approved medications include:

  • Acamprosate (Campral)
  • Disulfiram (Antabuse)
  • Naltrexone (Revia)
  • Topiramate (Topamax)
  • Ondansetron (Zofran)

How Does MAT Help Treat Opioid Addiction?

When someone becomes dependent on or addicted to opioid drugs, they must take them daily to function normally. If they are unable to access these drugs, they will start feeling sick or present drug-seeking behavior. 

An example of this includes a person addicted to pain medication and will take a more potent drug like heroin if they cannot get their hands on their drug of choice. The individual will do anything in their power to avoid the sickness, which is referred to as withdrawal. It consists of cravings and a desire for drugs to feel better. These symptoms pose the most significant challenge during the recovery process, but medication-assisted treatment will help remedy both withdrawal and sickness. 

In addition to using medication to combat cravings and the adverse symptoms of withdrawal, the individual will be part of a comprehensive treatment plan designed to address behavioral issues and safeguard their sobriety. It’s a rigorous process that requires a lot of fine-tuning, but once clinicians can tailor an approach they feel is right, it can lead to promising long-term results. 

How Does MAT Help Treat Alcohol Addiction?

Treating alcohol addiction requires a multi-faceted approach tailored specifically to the client. In some cases, medication-assisted treatment may be the best option. For someone struggling with alcohol use disorder, MAT will first consist of different treatment options that help get past the initial stages of withdrawal. Minimizing these symptoms with the help of medication will enable the client to participate in therapy much sooner. 

The option to medically assist a client struggling with alcohol use disorder has provided positive changes for those in addiction treatment programs. Since MAT helps clients feel comfortable, it will lead to them engaging throughout the treatment process, which means they’re more likely to succeed. MAT also helps individuals remain sober after completing a program at a higher rate than others who don’t use MAT.

When the process is used in conjunction with counseling and therapy, medication offers a better chance of sustaining the sobriety they’ve worked so hard to achieve.

Sources

Module 5: Assessing and Addressing Opioid Use Disorder (OUD). (n.d.). Retrieved from https://www.cdc.gov/drugoverdose/training/oud/accessible/index.html

Center for Drug Evaluation and Research. (n.d.). Information by Drug Class – Information about Medication-Assisted Treatment (MAT). Retrieved from https://www.fda.gov/drugs/drugsafety/informationbydrugclass/ucm600092.htm

Lynne.walsh. (2015, June 15). Medication and Counseling Treatment. Retrieved from https://www.samhsa.gov/medication-assisted-treatment/treatment

Secretary Price Announces HHS Strategy for Fighting Opioid Crisis. (2018, March 08). Retrieved from https://www.hhs.gov/about/leadership/secretary/speeches/2017-speeches/secretary-price-announces-hhs-strategy-for-fighting-opioid-crisis/index.html

National Institute on Drug Abuse. (2019, January 22). Opioid Overdose Crisis. Retrieved from https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis

American Family Physician. (May 2016). Medications for Alcohol Use Disorder. Retrieved from https://www.aafp.org/afp/2016/0315/p457.html

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