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Medication-Assisted Treatment

According to research, more than 60% of people who relapse after addiction treatment request medication-assisted treatment if they know it is available.[1] MAT is an approach that includes medication and behavioral therapy to treat addiction.[2] Relapse rates for people who do not use MAT tend to be higher. A study showed that 90% relapsed within a year, 65% relapsed within a month and more than 25% relapsed within the first day of completing initial treatment without MAT.[1]

Medication-Assisted Treatment

Medication-assisted treatment is commonly used for opiates, which are extremely addictive. This is an important consideration in New Jersey since heroin is a common drug that people misuse. According to 2020 reports from the state, more than 40% of addiction treatment admissions were for people using heroin.[3] About 7% of admissions were for people using other opiates. MAT is also used for alcohol addiction or other forms of addiction. In New Jersey, alcohol addiction accounted for 32% of treatment facility admissions in 2020.[3]

What Are the Goals of MAT?

The key goal of MAT is to help a person remain in recovery. Clinicians use MAT to prevent the likelihood of relapse, and they understand that the “cold turkey” method of completely stopping substances can be more harmful than helpful in many cases. These are the goals of medication-assisted treatment:

  • Balance brain chemistry
  • Remove euphoric effects
  • Reduce substance cravings
  • Stabilize bodily functions

Normally, a person going through detox and initial addiction treatment for a substance with high abuse potential may experience unpleasant side effects. For example, if a person tries to detox alone without clinical support or MAT, the individual may feel nauseous. It is also common to feel chills, shaking, irritability, and a wide range of other unpleasant symptoms. Since the brain chemistry of the person is also imbalanced because of the substance, cravings tend to be stronger.[4] The combination of unpleasant side effects and strong cravings is sometimes enough to push a person to relapse. One of the dangers of this quick relapse is a potential overdose. People often take larger doses when they relapse to ease the severe symptoms.

How Does Medication-Assisted Treatment Work?

The functions of MAT achieve the goals, which were mentioned in the previous section. Clinicians recommend a type of substance to substitute for the substance a patient was misusing. Addiction treatment professionals combine behavioral therapy with appropriate medication for each person.[5] Depending on the individual’s needs, the use of medications may be temporary, long-term, or permanent. How long a MAT program lasts may also depend on the person’s addiction history, risk of relapse, the type of drug, and more.

In behavioral therapy, professionals may use a variety of approaches. They typically use cognitive behavioral therapy to help people discover why they use substances. Also, some clinicians may uncover an underlying mental health issue or a history of trauma. By addressing the cause of behaviors or triggers, they improve treatment outcomes. Professionals teach patients strategies for dealing with triggers, coping with life, and avoiding relapse. They also recommend participation in 12-step meetings or similar support groups after people finish initial treatment or detox.

Medications Used in MAT

Medication substitution is often started during detox. During this time, professionals administer different medications while a person stops using the substance that was being misused. There may also be supportive medications that professionals use. For instance, a person who is experiencing anxiety or panic attacks may be given medications to treat those symptoms. Also, some people may receive other medications to treat side effects like diarrhea that are temporary.[6]

Opioid MAT Medications

The drugs approved by the FDA for opioid MAT are limited.[2] These are the main forms of medications used for medication-assisted treatment for opioids:

  • Naltrexone
  • Methadone
  • Buprenorphine
  • Naloxone

There are several variations of the top three drugs in the previous list. The variant names may be based on the administration route. For instance, there are injections, buccal, sublingual and other options for some.

Naloxone is a nasal spray that people can easily obtain from the pharmacy. It reverses the effects of opioids immediately, which makes it a valuable aid in preventing overdose incidents that may otherwise be fatal. According to the FDA, the other three medications are safe to use as long as a professional administers them and supervises the person taking them. Also, a supportive behavioral therapy plan is recommended by the FDA with these medications.[2]

People who use opioids experience an activation of brain receptors that create euphoric feelings and block pain. Heroin and prescription opioids are called opioid agonists. Opioid antagonists are substances that block those effects, and many of the MAT drugs for opioid addiction are antagonists. However, some are partial agonists, which means that they produce a smaller but similar effect of heroin or prescription opioids. Antagonists help reduce cravings and withdrawal symptoms.[6]

Alcohol MAT Medications

These are some of the medications used in MAT for alcohol addiction:

  • Naltrexone
  • Disulfiram
  • Acamprosate

Disulfiram is designed to create unpleasant side effects if a person consumes alcohol while taking it. If a person is already intoxicated and consumes it, the medication will produce the same effects. Acamprosate can help reduce cravings. It usually takes about eight days to reach its full effect, and people often begin taking it several days after they stop consuming alcohol.[7] It does not treat or prevent any symptoms of withdrawal. Naltrexone is a medication that may also be used for opioid addiction treatment. It prevents euphoric feelings, and that action can help people who are addicted to alcohol stop drinking.

The Role of Medication-Assisted Treatment in Detox

During detox, professionals may use MAT to help reduce cravings, prevent relapse or prevent some withdrawal symptoms. Without MAT, some people may find detox too difficult to handle. A doctor assesses each person to determine which medication is right if MAT is used. Maintaining medication-assisted treatment after detox may also be beneficial for some people to reduce the chances of relapsing. Without MAT, some people may relapse multiple times.[8]

What Is the Difference Between Medication-Assisted Treatment and Medication-Based Treatment?

The two terms are used to describe the same treatment method. One reason why there is some confusion as to which term is correct is that there are professionals who use them both. While some professionals prefer to use medication-assisted treatment as the main term, others believe that medication-based treatment, or MBT, is more appropriate.[9] When you contact an addiction treatment facility to discuss the treatment, the people will know what you are talking about when you use either of the two terms.

Benefits of Medication-Assisted Treatment

Research shows that MAT may be safer than treatment programs without medication in some cases.[10] These are some additional benefits:

  • Improves chances of staying in recovery.
  • Reduces recidivism or crime risks.
  • Improves cognitive function and social abilities.
  • Reduces risks of transferring infectious diseases.

In some cases, it may be a more cost-effective alternative to treatment without MAT. For example, if a person goes through MAT the first time and does not relapse, the long-term costs of treatment are lower. However, if that person goes through multiple relapses and treatment programs without MAT, the long-term costs are higher. As people relapse more, they may also be more likely to give up and stop trying to go back to detox or rehab. Because of its many potential benefits, professionals are using MAT more often.

Outcomes of MAT

The outcome of treatment depends on each person and many individual factors. However, research shows that MAT programs tend to produce favorable results. For example, one study showed that after over three years, more than 60% of people who went through a MAT program for opioid addiction did not consume substances during the past month. More than 90% no longer relied on opioids.[11] Additionally, the study found that MAT was especially helpful in maintaining sobriety for people who had co-occurring mental health issues.

Finding Medication-Assisted Treatment for Addiction in New Jersey

If you or someone you know is struggling with addiction, there is help. You may have heard about how unpleasant detox was for someone who tried to do it alone. Fortunately, detox does not have to be so dangerous or uncomfortable with support from professionals and a modern facility. Garden State Detox offers opioid and alcohol detox programs that fit individual needs. We also offer residential treatment, alcohol treatment, individual counseling, and therapy through telehealth. Our goal is to help people find the support they need and learn the keys to beating the cycle of addiction. To learn more about medication-assisted treatment for addiction in New Jersey, please contact us.

References
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4874241/
[2] https://www.fda.gov/drugs/information-drug-class/information-about-medication-assisted-treatment-mat
[3] https://www.nj.gov/humanservices/dmhas/publications/statistical/Substance%20Abuse%20Overview/2020/Statewide.pdf
[4] https://www.healthline.com/health/opioid-withdrawal/quitting-cold-turkey
[5] https://www.samhsa.gov/medication-assisted-treatment
[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3202507/
[7] https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions
[8] https://www.ncbi.nlm.nih.gov/books/NBK402343/
[9] https://www.cdc.gov/niosh/docs/wp-solutions/2019-133/pdfs/2019-133.pdf
[10] https://pcssnow.org/resource/benefits-medication-assisted-treatment/
[11] https://archives.drugabuse.gov/news-events/nida-notes/2015/11/long-term-follow-up-medication-assisted-treatment-addiction-to-pain-relievers-yields-cause-optimism