What Is Medication-Assisted Treatment (MAT)?

What is Medication-Assisted Treatment (MAT)?

MAT involves holistically using FDA-approved medications and therapy to treat substance use disorders (SUDs). This treatment approach is primarily used for opioid use disorder and alcohol addictions. 

“Research shows that a combination of medication and therapy can successfully treat these disorders, and for some people struggling with addiction, MAT can help sustain recovery.”

– Substance Abuse & Mental Health Services Administration

Healthcare providers use MAT with various evidence-based therapies and pharmacological treatments. The goal is to address different aspects of addiction, including:

• Physical
• Psychological
• Social
• Behavioral
• Spiritual

A multidimensional approach allows people to manage the multiple aspects of their substance use disorder simultaneously.

By targeting the underlying brain chemistry of addiction, medication-assisted treatment helps reduce cravings and withdrawal symptoms. It also allows for a gradual tapering off of the medications and helps people stay focused on their long-term recovery goals, reducing the risk of relapse.

How Does Medication-Assisted Treatment Work?

The use of medication-assisted treatment in treating substance abuse disorders can help:

The long-term benefits of MAT may include the following:

• Improved survival rates
• Increased treatment retention
• Decreased illicit opioid use and criminal activity among those with SUD
• Higher patient employment rates
• Improved birth outcomes in pregnant women with SUDs
• Lesser risk for HIV and hepatitis C

Types of Substance Addictions MAT Treats

MAT is currently approved to treat:

• Opioid use disorder
• Alcohol use disorder
• Tobacco use disorder

For alcohol use disorders, medications such as disulfiram, acamprosate, and naltrexone can be used in combination with counseling and support groups. These medications can help:

• Reduce withdrawal symptoms
• Reduce cravings
• Treat alcohol addiction
• Prevent relapse

MAT and the Opioid Epidemic

For opioid use disorder, medications such as buprenorphine, methadone, and naltrexone help reduce cravings and stabilize brain chemistry. They can be combined with other methods of treatment, such as:

• Behavioral therapy
• Cognitive-behavioral therapy
• Group therapy
• Family counseling

MAT is a recommended and evidence-based treatment for opioid use disorder. It is an essential element of comprehensive opioid treatment programs.

MAT treatment is integral to comprehensive opioid treatment programs, including:

• Extended-release injectable suspension medication
• Drug courts
• Counseling
• Behavioral therapies

This evidence-based treatment’s mental health services component also helps people recover from addiction effectively and safely.

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Types of MAT Medications

The FDA has approved the following medications for MAT:

• Methadone
• Buprenorphine
• Naltrexone
• Naloxone (Narcan)
• Disulfiram
• Acamprosate

Off-Label Medications Used to Treat Drug Addiction

In addition to FDA-approved medications, physicians may prescribe off-label treatments for substance use disorders. These drugs aren’t explicitly approved for substance use disorders, but they’re effective treatment options for symptoms associated with addiction.

Similarly, these off-label medications may have euphoric and sedative adverse effects, so they must only be used under the supervision and guidance of a qualified healthcare professional.

Antipsychotics 

Antipsychotics treat psychosis rather than substance abuse. They also effectively manage alcohol and drug use linked to mental illness.

Anticonvulsants

Anticonvulsants include topiramate and gabapentin, which have shown promising results in treating alcohol use disorder.

Beta-Blockers 

Beta-blockers are primarily used to prevent heart attacks, angina, and migraines. They’re also used off-label for drug and alcohol rehab, including in cases of co-occurring disorders.

Clonidine

Clonidine is an anti-hypertensive medication. It blocks chemicals in the brain that trigger sympathetic nervous system activity, reduce anxiety, and speed up detoxification. It can also treat opioid dependence by reducing withdrawal symptoms. Clonidine doesn’t cure addiction but does make relapse less likely.

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MAT for Opioid Addiction

The medications used in MAT don’t cure opiate dependence but help people abstain from the substance.—some block withdrawal symptoms, while others block euphoria.

The following medications may treat opioid use disorder:

Methadone

Methadone is one of the most commonly prescribed medications to treat opioid dependence. It’s a full opioid agonist, meaning it activates the opioid receptors in the brain. This alleviates cravings and withdrawal symptoms and blunts the effects of opioids. 

Methadone should only be used under a doctor’s direct supervision. It’s the only MAT drug approved for pregnant or breastfeeding women.

Buprenorphine

Buprenorphine is a partial opioid agonist. It produces effects similar to other opioids. However, they are much weaker.

People are unlikely to abuse it because of its “ceiling effect.” This means more doses don’t trigger additional side effects. Like methadone, it reduces cravings, withdrawal symptoms, and the effects of other opioids.

Naltrexone

Naltrexone works differently than Methadone and Buprenorphine because it’s an opioid antagonist. This means it blocks the consequences of drugs.

If someone relapses while taking it, they won’t experience the euphoria they did in the past. Naltrexone can also treat AUD.

Naloxone (Narcan)

Naloxone is used to treat someone who overdosed on heroin, morphine, oxycodone, and other types of opioids. It works by blocking their effects.

Naloxone can be administered as a nasal spray or an injection. When given, it counters the effects of an opioid overdose. Administering naloxone may cause a person to experience withdrawal symptoms like vomiting, shaking, and sweating. 

MAT for Alcoholism

These medications don’t cure AUD but can effectively control cravings and block their euphoric effects.

Disulfiram

Disulfiram alters the body’s alcohol metabolism, leading to vomiting when alcohol is consumed.

Other possible side effects of drinking alcohol while taking it include headaches and nausea. Disulfiram is most effective in people who have already undergone detoxification or are in an early stage of abstinence.

Acamprosate

Acamprosate is for people who have already stopped drinking and want to continue sobriety.

It doesn’t prevent withdrawal symptoms immediately after you stop drinking. It’s prescribed five days after abstinence begins and is fully effective in another five to eight days. 

Naltrexone

Naltrexone blocks the euphoric effects of alcohol. It helps people reduce their drinking and increases their motivation to stay in treatment and avoid relapses.

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How Effective is MAT?

MAT’s treatment approaches are effective in helping people overcome substance use disorders. It’s an evidence-based form of treatment, which means there is research proving its effectiveness.

According to the SAMHSA, MAT is “clinically effective” and significantly reduces the need for inpatient detoxification. Such therapies, when combined with medications, also help prevent overdose.

A study found that deaths from opioid overdoses reduced as treatment with Buprenorphine became more popular in Baltimore.⁸ MAT helps people maintain recovery from substance use and misuse by:

• Addressing chemical imbalances
• Relieving psychological cravings
• Improving life
• Increasing survival and retention in a treatment program

However, although ample evidence supports the success and efficacy of MAT, there are still gaps in the scientific literature that need to be addressed. MAT isn’t approved or recommended for treating all types of addiction.

Cost of MAT

Medication-assisted treatment costs vary significantly from program to program. It depends on the drug administered and other factors.

• Methadone treatment costs about $126.00 per week or between $4,000 and $7,000 yearly
• Buprenorphine costs approximately $115 per week or just under $600 annually
• Naltrexone costs about $1,200 monthly or $14,100 annually

Does Insurance Cover MAT?

Some insurance can cover medication-assisted treatment. Treatment coverage for SUDs became more widely available following the passage of the Affordable Care Act.

The Mental Health Parity and Addiction Equity Act of 2008 also requires insurance providers to offer the same benefits for mental and substance use treatment as they do for medical and surgical care.

Does Medicaid Cover MAT?

Medicaid programs and what they cover vary from state to state. For example, most state Medicaid plans cover methadone treatment.

States that don’t cover methadone treatment include:

• Arkansas
• Idaho
• Kansas
• Kentucky
• Louisiana
• Nebraska
• North Dakota
• South Carolina
• Tennessee
• Wyoming

Most states also cover suboxone treatment, but there are specific requirements regarding amounts and administration. The best way to determine the available financial support is to contact a specific state’s Medicaid office.

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What Is Medication-Assisted Treatment (MAT)?

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Summary

Medication-assisted treatment (MAT) is an evidence-based approach that’s effective in reducing relapse rates and helping people achieve sobriety. It’s also cost-effective, with most insurance plans and Medicaid programs covering some costs.

If you’re struggling with addiction, MAT can be a viable option for achieving and maintaining recovery. Talk to your doctor today and determine if MAT is right for you.

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