The opioid epidemic continues to get worse in the United States. Since the 1990s, communities across America have been heavily impacted by the opioid epidemic, which includes both prescription opioids and illicit drugs like heroin and fentanyl. Overdose deaths are a leading cause of injury-related deaths in this country, but there are resources available to help people struggling with opioids and addiction.
One approach is called medication-assisted treatment, which relies on a combination of approved prescription medicines like Suboxone and therapy.
Below, we go into more detail about what medication-assisted treatment is and how it helps people, whether you’re personally dealing with an opioid use disorder or you’re looking for help for someone you love.
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The Basics
Medication-assisted treatment is used to treat different substance use disorders, including not only opioid use disorder but also alcohol use disorder.
MAT combines medications with behavioral therapies and counseling for a whole-person approach to treating substance use disorders.
The medications used in MAT have approval from the FDA, and these programs are very much tailored to the needs of the individual person.
Research indicates that MAT can be a successful treatment approach and can lead to sustained recovery.
The goal of MAT is to help patients live self-directed life. Benefits of an MAT approach include increased patient survival and retention in treatment, improvements in the ability of patients to get employment and stay employed, and better birth outcomes in women with substance use disorders during pregnancy.
What Medications Are Used?
There are several medicines with FDA approval for MAT programs.
For alcohol use disorders, medications include acamprosate and disulfiram. These medicines don’t cure an alcohol use disorder, but they help people receive other holistic treatments at the same time.
For opioid dependence, there are three primary medicines that are used—buprenorphine, methadone, and naltrexone.
Buprenorphine is a medication that is available in brand names like Suboxone as well as injectable versions and other formats. Buprenorphine works as an opioid partial agonist. The effects of buprenorphine are weaker than methadone or heroin. Methadone is considered a full opioid agonist.
The goal of treatment with buprenorphine is to reduce the effects of physical opioid dependence, including withdrawal symptoms. It can be safer if someone overdoses and buprenorphine has a lower risk of misuse than methadone.
If a patient is prescribed buprenorphine, they first have to not use opioids for at least 12 to 24 hours and be starting the early stages of withdrawal. If someone still has opioids in their bloodstream when taking buprenorphine, they could experience acute withdrawal.
How long someone continues on buprenorphine or other medication-assisted treatments depends on their individual needs.
Naltrexone is a medicine approved for treating both opioid and alcohol use disorders. Unlike methadone and buprenorphine, naltrexone isn’t an opioid, it’s not addictive, and it won’t cause symptoms of withdrawal when someone stops using it. Naltrexone works by blocking the euphoric and also sedative effects of opioids. Naltrexone can bind to and then subsequently block opioid receptors, reducing opioid cravings.
Behavioral Therapy
Behavioral therapy is also a key part of an effective MAT approach to addiction. When someone participates in behavioral therapy, they can learn how to change their thoughts and behaviors related to substance use, increase their life skills, and they can work toward staying consistent with other forms of treatment, including medication.
Behavioral therapy for addiction can be provided in different settings, including an inpatient or outpatient environment and in a group or individual setting.
Cognitive-behavioral therapy, or CBT, is one type of therapy used for addiction. It was originally designed to treat depression, but now it’s widely used for a range of conditions. CBT teaches people who are dealing with substance misuse and addiction to identify triggers and problem behaviors and then create effective coping strategies.
Understanding That Addiction is a Disease
Researchers know, after decades of work on the topic, that addiction is a disease. Addiction likely occurs because of genetic and environmental factors, which is true of other chronic diseases as well.
When someone has an addiction to opioids or other substances, it affects them mentally and physically, as well as socially.
Medications can be part of treating the physical components of addiction. Medications can, for example, help someone get through withdrawal more comfortably, making it more likely they then continue on with their treatment program. Medications can also help someone stay on track with their recovery even after they complete a treatment program. They can be powerful tools when used correctly in a well-supervised treatment program.