Although medication-assisted treatment (MAT) can be a useful component of a successful recovery program, it is underutilized. MAT should be one component of a recovery program that also includes behavioral interventions like substance use disorder therapy and support group participation.
There is no cookie-cutter application for the use of any MAT program. Its use depends on the person’s specific circumstances and other variables.
Medications can be used at numerous stages of recovery. They may be used to:
- Control withdrawal symptoms
- Reduce cravings
- Reduce or halt the consumption of a particular substance
- Address issues, such as depression, that may increase the risk of relapse
The goal of using most medication-assisted treatments is to control a specific set of conditions at a certain stage of recovery. After those conditions are addressed, the person is weaned off the medication, as they can replace negative behaviors with more functional behaviors.
Pros of Using MAT in Recovery
There are many advantages to the use of MAT in a recovery program. Among them are the following:
- Medications can reduce the discomfort of withdrawal from alcohol or drugs.
- The use of MAT can be lifesaving. Medication can control potentially dangerous seizures during withdrawal from alcohol or stabilize emotional state when a person has suicidal tendencies.
- Some medications can help to reprogram the brain. This may foster conditions that can increase the chances of a successful recovery.
- Medications can help to readjust imbalances in neurotransmitters and hormones.
- A recovery program that includes MAT will require that the person is under the supervision of a medical professional. This can be useful in addressing other physical and medical conditions.
- MAT can be used in a variety of situations for different issues. Use can be easily adjusted to fit the needs of the person. It can be applied on both a short-term and long-term basis.
- MAT comes with reduced relapse risk. When symptoms are under control, the person can more effectively participate in therapy.
- Since medications allow for stabilization, MAT can increase confidence. Individuals can feel assured that they can address the challenges that lie ahead.
- MAT can be applied over a wide range of environments, including in hospitals, residential programs, outpatient treatment programs, and prisons.
- Studies have demonstrated that a combination of medications and behavioral interventions can be successful in assisting individuals in recovery.
Cons of Using MAT in Recovery
There may be a downside to the use of MAT for some individuals.
- Medications can be costly. People without insurance coverage may not be able to afford them.
- Since MAT requires physician supervision, it may involve additional costs beyond those associated with the purchase of the medication.
- All medications carry potential side effect profiles, which can produce significant discomfort in some individuals.
- The use of MAT may produce adverse reactions to other medications that a person takes or even to certain types of food.
- Some people in recovery may incorrectly assume that because they are using medication, other aspects of recovery are not important to them. Some people may use medications as a crutch or an excuse not to participate in other necessary interventions.
- Some of the medications that are used for MAT are potential substances of abuse themselves.
- In some cases, medication is used as a replacement drug. This has led to critics implying that society is fostering addictive behaviors.
- Although research findings are generally positive, some forms of MAT have been shown to have relatively poor outcomes.
MAT sometimes draws criticism from others in recovery, such as those who attend peer support groups like Narcotics Anonymous. This can lead to feelings of shame or confusion for those who use MAT.
How to Decide If MAT Is Appropriate
No set guidelines can help you decide if using medications for recovery is necessary or appropriate for you. However, there are general considerations that can help inform your decision.
For many people, the cost of MAT is a deciding factor. Over the long term, the benefits associated with successfully recovering from any substance use disorder will far outweigh any financial costs incurred from treatment. In many cases, insurance will cover a significant portion of the costs of MAT.
Reluctance to Use Medications
Some people in recovery are reluctant to use medications. People in the early stages of recovery from a substance use disorder may reject the idea of using medications as part of their recovery program because they don’t want to be taking any substances.
A substance use disorder represents a diagnosis of a serious psychological disorder that needs treatment. Medications can be an important part of that treatment.
With MAT, the goal isn’t to be on medication indefinitely. The medications serve to stabilize those in the earlier stages of recovery. Over time, their use will be gradually tapered, and eventually, the person will be free of all substances.
The Bottom Line
The majority of people in recovery from any substance use disorder can benefit when a MAT is incorporated into their program. MAT should be supervised by a medical professional, preferably an addiction medicine physician or psychiatrist. Those in recovery should feel free to ask questions regarding any suggested medications.
Ultimately, the decision to use MAT should be made by the individual in consultation with their treatment providers. There are pros and cons to the use of any medication, but when MAT is recommended, the benefits generally far outweigh the potential disadvantages.
How Effective Is Medication-Assisted Treatment?
According to the most recent statistics released by the National Institute on Drug Abuse (NIDA), more than 2.5 million Americans struggle from opioid use disorder (OUD), which contributed to 28,000 overdose deaths in 2014.
The use of these drugs, including heroin or prescription pain relievers, can lead to neonatal abstinence syndrome. It can also cause the spread of infectious diseases such as hepatitis and HIV (human immunodeficiency virus).
Buprenorphine and methadone have been established to be essential medicines, according to the World Health Organization (WHO), and these medications must be combined with behavioral counseling for a “whole client” approach. MAT decreases opioid use, opioid-related overdose deaths, criminal activity, and infectious disease transmission.
In addition, MAT increases social functioning and retention in treatment. MAT has also shown to be effective in treating opioid-dependent pregnant women, which also improves outcomes for their babies. MAT will reduce the symptoms of neonatal abstinence syndrome and length of hospital stay.
One myth is that methadone or buprenorphine are substituting one addiction for another – on the contrary, however, and the dosage of medication used will not allow the individual to be high. It is designed to reduce opioid cravings and withdrawal, and they restore balance to the brain circuits most affected by addiction.
Currently, less than half of private substance use treatment programs offer MAT, and only one-third of clients with opioid dependence receive MAT. The proportion of opioid treatment admissions with plans that included receiving medications dropped from 35 percent in 2002 to 28 percent in 2012.
A majority of states do not have sufficient treatment capacity to offer MAT to all clients with opioid use disorders (OUD).
