A common misconception associated with MAT is that it substitutes one drug for another.

But actually, these medications relieve the withdrawal symptoms and psychological cravings that cause chemical imbalances in the body.


Research has proven that this is the case when it comes to addiction to opioids.1 Medication-assisted treatments substantially improve the odds of successful recovery for people who misuse opioids, including heroin and prescription painkillers.2

Addiction to opioids has reached epidemic proportions in the United States. In 2015, accidental drug overdoses surpassed car accidents as the leading cause of accidental death according to the Drug Enforcement Administration (DEA),3 and the American Society of Addiction Medicine says that more than two million individuals in the US are addicted to opioids.4 

Opioids and the brain

So what’s unique about opioid addiction? Opioids are so addictive—and so dangerous—because of the way in which they affect the brain’s pleasure center.These drugs work by attaching to the brain’s receptors and sending signals that block pain, slow breathing, and promote a feeling of calmness.They also flood the brain’s circuits with dopamine—that “feel-good” chemical that sends the brain feedback about rewards—creating a feeling of euphoria.For the sake of survival, our brains are naturally wired to repeat behaviors associated with pleasure or reward. So, when that reward system is over-stimulated by the effects of opioids, the brain remembers that behavior and records it as something that should be repeated without even thinking about it.8

Due to the way opioids affect the brain, behavioral treatments alone, like therapy and 12-step programs, have been proven to be less effective.However, significant research has shown that the use of medication can be very effective in helping opioid users stay in recovery for years or decades.10

MAT options

There are a few drugs that are commonly used in the maintenance of opioid use disorder: methadone, buprenorphine, and naltrexone. Methadone is available as an oral tablet, liquid, or wafer from licensed opioid treatment clinics only—and a person in recovery must visit the facility daily to receive treatment. Buprenorphine, which is usually combined with naloxone, is available as a tablet or film placed under the tongue or against the inside cheek or as an implant inserted in the patient’s arm by a physician. Doctors must be specifically credentialed to use buprenorphine to treat patients.

Methadone

Methadone has been used to treat addiction to opioids, including heroin, since the 1960s. Extensive research has been conducted in Australia, Europe, Asia and the United States, and the evidence overwhelmingly shows that methadone treatment is directly related to a reduction in opioid use, particularly when it comes to heroin.

Buprenorphine

Buprenorphine is a newer treatment option and was approved by the FDA in 2002. It works by attaching to the brain’s neurotransmitters to help lower potential for misuse by diminishing effects of dependency (such as withdrawal symptoms and cravings), and producing a lower level euphoric effect that essentially “tricks” the brain into being satisfied.

Naltrexone

Naltrexone is another medication-assisted treatment (MAT) to treat both opioid and alcohol use disorders.

MAT as part of recovery

Many doctors and other experts have come out in support of MAT as part of a recovery plan for substance use disorder. The American Medical Association (AMA), the American Academy of Addiction Psychiatry (AAAP) and the American Society of Addiction Medicine (ASAM) all support the use of medication-assisted treatments.12 Alcoholics Anonymous and Psychiatric Medication have also advocated for the use of MAT.13

The best way to overcome the myths about Medication Assisted Treatment is through information and education.


Consider the following facts:

  • Science has proven that substance use disorder is a disease14
  • Opioid use causes actual changes in the brain15
  • Brain chemistry changes can be managed with medication16
  • Many people with chronic conditions manage them with medication, including persons with diabetes and asthma
  • MAT is supported by the American Medical Association (AMA), the American Academy of Addiction Psychiatry(AAAP), and the American Society of Addiction Medicine (ASAM)
  • Research has shown MAT for opioids is effective17
  • Persons in recovery who incorporate MAT can stay substance-free for decades18

MATs have been proven very effective in avoiding relapse and fatal overdose, and staying in recovery.19 Of course, every treatment plan should be tailored to the unique needs of the person in recovery, and medication may be used in combination with other therapies. Understanding all of your options and incorporating all of the treatments available will only improve your odds of success. Treatment decisions should be made in consultation with a trained physician.

1-2.Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov/medication-assisted-treatment/treatment “Medication and Counseling Treatment”
3. Drug Enforcement Administration. https://www.dea.gov/divisions/hq/2015/hq110415.shtml “Drug Threat Assessment: Heroin and Painkiller Abuse Continue to Concern."
4. American Society of Addiction Medicine http://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf
5-8. Kosten, Thomas R and Tony P. George. “The Neurobiology of Opioid Dependence: Implications for Treatment” Sci Pract Perspect. 2002 Jul; 1(1): 13–20. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851054/
9-10. Substance Abuse and Mental Health Services Administration. “Medication Assisted Treatment for Opioid Addiction: Facts for Friends and Family.” HHS Publication No. (SMA) 09-4443. 2011
11. Baxter, Sr., Louis, MD FASAM. “Twelve Step Recovery and Medication Assisted Treatment.” American Society of Addiction Medicine Magazine. 2014
12-13. National Institute on Drug Abuse. https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction “DrugFacts: Understanding Drug Use and Addiction"
14. Kosten, Thomas R and Tony P. George. “The Neurobiology of Opioid Dependence: Implications for Treatment” Sci Pract Perspect. 2002 Jul; 1(1): 13–20. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851054/
15. Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov/medication-assisted-treatment/treatment “Medication and Counseling Treatment”
16. Substance Abuse and Mental Health Services Administration. “Medication Assisted Treatment for Opioid Addiction: Facts for Friends and Family.” HHS Publication No. (SMA) 09-4443. 2011
17. Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov/medication-assisted-treatment/treatment “Medication and Counseling Treatment”
All Drug and Side Effect Information Provided By:
http://www.rxlist.com/script/main/hp.asp
http://www.webmd.com/drugs/index-drugs.aspx?show=drugs
http://www.drugs.com