Medication-Assisted Treatment (MAT) Options for Addiction
Medication-assisted treatment (MAT) is quite possibly the most effective tool in the fight against drug and alcohol addiction. It is supported by research and medical professionals alike. But is MAT right for you?
What is Medication-Assisted Treatment?
Medication-Assisted Treatment, or MAT, is the use of FDA-approved medications and counseling to treat substance use disorders. It provides options to aid in both the detox process as well as relapse prevention. However, long-term success of MAT is largely dependent on the continued utilization of behavioral therapies like counseling, support groups and aftercare programs.
A common myth about medication-assisted treatment is that it just trades one addiction for another. Yet most medications used are not addictive and those that are incorporate harm-reduction to reduce accidental overdoses and allow you to return to daily activities. MAT, while often associated with rapid opiate detox and maintenance therapy, also includes medication management and counseling for alcoholism, cocaine and benzodiazepine addictions. For now, we will focus on common medications used in the treatment of opioid and alcohol use disorders.
MAT for Opioid Addictions
Buprenorphine and Naloxone
One of the most widely used medications approved by the FDA for the treatment of opioid use disorder (OUD), buprenorphine serves two main purposes. It can be beneficial during both stabilization to ease withdrawal symptoms as well as throughout the maintenance phase by minimizing cravings. In fact, recent studies by the U.S. Dept. of Health and Human Services have actually found better outcomes with maintenance therapy than by tapering buprenorphine. The drug can also be combined with naloxone, the popular medication used to reverse the effects opioid overdose, in order to help prevent misuse.
Buprenorphine, or bupe, is an opioid partial agonist, meaning it can produce similar, although weaker effects than full agonists like heroin and Vicodin. Furthermore, these effects have a ceiling at moderate dosages which deters abuse. The drug works by binding to and partially activating mu opioid receptors in the brain, enough to suppress the effects of withdrawal and cravings. For MAT, it is prescribed as either a dissolvable film which also contains naloxone (Suboxone), sublingual tablet containing only buprenorphine (Subutex), a once monthly injection (Sublocade), or six-month implant (Probuphine).
It may seem as though, since buprenorphine is partial agonist and naloxone is a full antagonist, the two would interact and send the user into opioid withdrawal. However, the naloxone has poor bioavailability when taken orally and thus only helps deter abuse of buprenorphine. But it is absorbed better when when injected. Thus, if the oral bup/naloxone tablets were to be crushed and injected, the user would likely enter full opioid withdrawal.