Not everyone who enters an addiction treatment program will respond to the same treatment plan. That’s why treatment needs to be unique and tailored to a person’s individual needs. In some cases, people go through treatment multiple times and continue to relapse.
Chronic relapse involves someone who is caught in a cycle of active addiction, sobriety, and relapse. Though these cases are more challenging to overcome, people who struggle with chronic relapse achieve sobriety all the time.
In some cases, people who struggle with chronic relapse need medication-assisted treatment, or MAT, a method that uses specific drugs and therapies to treat substance use disorders. Medications may be used to treat substance use disorders that involve alcohol or opioids. In some cases, medications work similarly to the person’s drug of choice, with fewer side effects, to stave off withdrawal symptoms and cravings.
MAT is intended to help people who have tried and failed to achieve lasting sobriety, perhaps multiple times. Treating withdrawal symptoms and cravings without causing intoxication can help people go about their lives, maintain employment, and pursue meaningful goals. It may also help someone complete a treatment plan without having to start by going through an uncomfortable withdrawal process.
Learn more about MAT services and who they may be able to help.
How Medication-Assisted Treatment Works
Medication-assisted treatment uses medications to treat addiction symptoms like drug cravings in conjunction with counseling and behavioral therapies. It is often called a “whole-patient approach” because it seeks to treat the physical, mental, and behavioral components of a substance use disorder. It is primarily used to treat opioid use disorder, but a few medications may be used to treat alcoholism.
MAT for opioid use disorder involves the use of opioid agonists like methadone or partial opioid agonists like buprenorphine. These medications work similarly to opioids of abuse like heroin. However, in normal doses, they can prevent withdrawal symptoms without causing significant intoxications. Active opioid addiction often involves a cycle of intoxication and withdrawal that makes it challenging to maintain employment, form personal relationships, and live a productive life. These medications can help a person break the cycle of active addiction to concentrate on their recovery and other life goals.
The use of opioid medications to treat opioid use disorder has been controversial. Medications like methadone have been used to replace opioids of abuse with no plan to taper a patient off the drug. Methadone is also reported to cause a harsh withdrawal phase, even when compared to other opioid drugs. Though MAT drugs are strictly monitored and given in only single doses, they can cause intoxication when misused.
Methadone has been associated with a negative stigma, where methadone clinics give out daily doses to people struggling with substance use disorders. Critics point out that it often attracts drug dealers who prey on people that need help.
However, today’s MAT is more closely tied to a broader treatment program, and medication is ideally used alongside other treatment methods. MAT may require a client to be dependent on a drug for longer than traditional treatment without medications. However, MAT can involve a tapering plan to eventually become independent of both opioid medications and harmful drugs of misuse.
Quitting Cold Turkey
Drugs like opioids and depressants can cause chemical dependence, which is when your brain chemistry adapts to the presence of a foreign substance. After a period of dependence, quitting the drug will cause your brain chemistry to become unbalanced suddenly. This period of unbalance creates uncomfortable symptoms of withdrawal.
The specific symptoms you encounter will depend on the drug you’ve become dependent on. The severity of your symptoms will depend on several factors, including how long you used the drug, your average dose, and the size of your last dose.
Depressants like alcohol and benzodiazepines are the most dangerous drugs when it comes to their withdrawal symptoms. They can cause seizures and a condition called delirium tremens, which can be fatal without medical intervention. For that reason, it’s usually advised to speak to a doctor before quitting a depressant abruptly.
Opioids are less dangerous during withdrawal, but symptoms can be extremely unpleasant. Opioid withdrawal is often compared to the flu with symptoms like sweating, nausea, diarrhea, vomiting, fatigue, and powerful drug cravings. In some cases, sweating, vomiting, and diarrhea can lead to dehydration, especially if you can’t keep fluids down.
While opioid withdrawal isn’t deadly in most cases, it’s a good idea to speak with a doctor before quitting cold turkey. Even if it’s not deadly, quitting opioids cold turkey without professional help may lead to relapse.
Quitting cold turkey can cause more severe withdrawal symptoms than going through a tapering period. However, tapering is difficult to do on your own. Cravings usually make a full dose hard to resist. Taking too much will make your taper ineffective, but taking too little will cause uncomfortable withdrawal.
What Drugs Are Used in MAT?
When you go enter an addiction treatment program, you may be given medications to help treat symptoms, to help you sleep, or to manage anxiety. While various medication options are available to treat symptoms of addiction and withdrawal, only a few drugs are approved to treat the addiction itself.
MAT For Alcohol Use Disorders
Disulfiram is a drug that can help treat alcohol addiction by creating an unpleasant feeling whenever anyone drinks alcohol while on the drug. The drug, sold under the name Antabuse, blocks the degradation of alcohol, causing nausea, hot flashes, and heart palpitations. The idea behind this drug is to create an unpleasant association with alcohol in your brain.
Since addiction is your brain adapting to the rewarding effects of alcohol, perhaps unpleasant feelings will cause you to avoid it instead of craving it. The main drawback of this medication is that it incentivizes not taking your medications. Med-compliance is an important part of treatment with this drug.
Acamprosate is another medication that’s used to treat alcohol use disorders. It’s sold under the brand name Campral, and it interacts with gamma-Aminobutyric acid (GABA) receptors, the same receptor that interacts with alcohol. Acamprosate is thought to lessen symptoms of withdrawal like insomnia, anxiety, and restlessness.
MAT For Opioid Use Disorder
There are a few medications that can work on opioid receptors to help avoid opioid withdrawal. Methadone is one of the most commonly used drugs to treat opioid addiction. Methadone itself is an opioid that can bind to opioid receptors to satisfy cravings and prevent withdrawal symptoms. Methadone doesn’t cause intoxication as easily as other opioids like heroin, so people who take the drug can avoid withdrawal and intoxication.
Methadone can cause a euphoric high if it’s taken in high doses. Methadone withdrawal is also said to be more unpleasant than withdrawal from other opioids. Very high doses of methadone can cause a deadly overdose like other opioids.
Buprenorphine is another common opioid medication. It’s a partial opioid agonist, which means it binds to and activates opioid receptors, but it’s weaker than other opioids that are full agonists. It can satisfy cravings without causing intoxication, perhaps more efficiently than methadone. An overdose is less likely on buprenorphine than on methadone.
