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Medication Assisted Treatment (MAT): What Drugs Are Used in Rehab?

Medication-assisted treatment (MAT) has helped many people recover from certain types substance use disorders (SUDs). If you or someone you care about are struggling with alcohol or opioid addiction, you may be interested in learning more about how MAT can help you make progress in recovery.

American Addiction Centers offers medication-assisted treatment at most of our nationwide treatment facilities. Call to find out more about MAT options at AAC.

What is Medication-Assisted Treatment?

As would be expected given the name, medications are an indispensable element of medication-assisted treatment methods—but they aren’t the only component of such treatment. Instead, medication-assisted treatment entails a combined approach to treat substance use disorders. MAT combines pharmacological treatment (medications) with behavioral treatment that is tailored to a patient’s unique needs. Many people have been helped in recovery through this whole-patient-focused approach.1 In its various forms, MAT may effectively minimize cravings, block some of the rewarding properties of certain substances, and ultimately decrease drinking and continued substance use behavior. The goal of MAT is full recovery; however, MAT has also been shown to:1

  • Increase patient survival rates.
  • Increase treatment retention rates.
  • Decrease criminal activity related to opioid use and other drug use.
  • Increase patents’ ability to gain or maintain employment.

MAT is a comprehensive approach to treatment; in its various phases, it incorporates strategies to address several components of your life, including vocational issues, medical and mental health concerns, family issues, and legal concerns through monitoring, support, screening, referrals, and counseling.2

MAT was originally designed to treat opioid use disorder (OUD) in the 1960s when methadone maintenance was developed as one of the key forms of treatment for this problem. Federally-funded treatment programs emerged in the 1970s; the term “maintenance treatment” (referring to medication-assisted treatment) was first used in the Narcotic Addict Treatment Act of 1974.

In the 1990s, the National Institutes of Health published important recommendations clarifying that opioid addiction was not due to a lack of willpower or a moral failing, but a treatable disorder. This helped further promote the concept of addiction as a medical condition, widened the search for and adoption of medication-assisted treatment options, and may have also helped to reduce some of the stigmas associated with MAT. Soon, other treatments and medications developed, and MAT became more widely used. Finally, accreditation systems for opioid treatment programs (OTPs) helped standardize treatment methods in MAT and ensure high-quality MAT services across the United States.2

What are the Components of MAT?

MAT combines FDA-approved medications with various behavioral therapies for addiction treatment. This combination has proven effective for the comprehensive treatment of certain substance use disorders. It allows for the simultaneous pharmacological management of some of the physical symptoms associated with substance use (or substance withdrawal), as well as behavioral therapeutic interventions for related psychological, mental, and emotional issues.1

Before you enter an MAT program, you will undergo a thorough assessment by a physician. This assessment will help your physician determine the appropriate course and level of medication-assisted treatment, including the best medications for your particular needs.3

Patients often start with a period of medical detox to help them become stable as they withdraw from the substance.4 They may then progress through a more rehabilitative phase of a treatment program that strives to empower them to better cope with major life issues. All the while, a combination of medication and therapy will continue to be utilized. At the completion of the more rehabilitative and supportive phases of MAT, a patient will transition to medical maintenance treatment that mainly involves medication to help manage their SUD in the longer term.2,6

MAT drugs that you may receive can vary depending on the type of substance use disorder being treated. In cases of opioid use disorder management, treatment medications may at some point be gradually tapered off (though long-term maintenance may last for several years, if not indefinitely).2 MAT medications can be used to treat the following conditions:

  • Alcohol use disorder (AUD). You may receive: 1,3,4
    • Acamprosate. This helps people who are already in recovery to avoid alcohol use. You may receive it starting on the 5th day of abstinence. It does not prevent withdrawal symptoms but helps you avoid alcohol use.
    • Disulfiram. This is designed to decrease drinking behavior in people who have already detoxed or have begun a period of abstinence. It causes unpleasant symptoms if you drink, so it can help decrease relapse risks when taken daily.
    • Naltrexone. This helps block some of the rewarding or reinforcing effects of alcohol, to decrease the likelihood of continued drinking.
  • Opioid use disorder (OUD). You may receive: 1,3,4
    • Buprenorphine. This partial opioid agonist has a very high affinity for opioid receptors. It can reduce cravings and minimize some of the uncomfortable symptoms of opioid withdrawal.
    • Methadone. A longer-acting, full opioid agonist, methadone reduces withdrawal symptoms and cravings and through the development of cross-tolerance, may diminish the euphoric high of other opioids, should they be used during methadone treatment.
    • Naltrexone. This opioid receptor antagonist blocks the euphoric and sedating effects of opioids. When utilized for OUD treatment, it may help to suppress opioid cravings and discourage continued opioid misuse.

MAT therapy may also consist of or occur alongside different behavioral interventions, such as:2

  • Cognitive-behavioral therapy (CBT) to help you identify and change unhelpful behaviors and thoughts about yourself and your addiction.
  • Contingency management (CM) to help you stay motivated by providing tangible rewards (like vouchers for goods) for positive changes.
  • Community reinforcement approach (CRA) to help identify your reasons for wanting to make changes in your life and find healthier ways of coping with stress and other triggers to abuse substances.
  • Motivational enhancement (ME) to help you engage and stay motivated in treatment.
  • Group therapy. This can include a variety of groups, such as psycho-educational, skills development, cognitive-behavioral, interpersonal process, or support groups.

Take Our Substance Abuse Self-Assessment

Take our free, 5-minute substance abuse self-assessment below if you think you or someone you love might be struggling with substance abuse. The evaluation consists of 11 yes or no questions that are intended to be used as an informational tool to assess the severity and probability of a substance use disorder. The test is free, confidential, and no personal information is needed to receive the result.

MAT Statistics, Effectiveness & Goals

According to the 2019 National Survey on Drug Use and Health and the National Survey of Substance Abuse Treatment Services:5,6

  • 5 million people aged 12 and older had an alcohol use disorder in 2019.
  • 1. million of these people received some sort of substance abuse treatment for AUD.
  • Out of these 1.1 million people, 228,000 received MAT for AUD.
  • In addition, 2.5 million people received alcohol use treatment in 2019 (regardless of whether they had an AUD).
  • Out of these 2.5 million people, 286,000 received MAT for alcohol use.
  • Out of 2.3 million people aged 12 and older who received treatment for illicit drug abuse (including opioids) in 2019, 664,000 people received MAT for opioid abuse.
  • Out of 1.6 million people aged 12 and older with an OUD, 294,000 received MAT.
  • 408,550 people received methadone treatment in OTPs in a single-day count in March 2019.
  • 168,428 people received buprenorphine treatment in OTPs in a single-day count in March 2019.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), MAT has been proven to be effective in clinical studies and has been shown to significantly decrease the need for inpatient detox. By reducing the risk of relapse, MAT for opioid use disorder may also lower the risk of contracting HIV or hepatitis C.1

Confidentiality of MAT & Treatment

You can rest assured that your MAT treatment will be confidential. According to SAMHSA, the Confidentiality Regulation, 42 Code of Federal Regulations (CFR) 2, personally identifiable health information relating to MAT treatment must be handled with a higher degree of confidentiality than other medical information.1 This means that a MAT program is generally prohibited from disclosing information that identifies you as having or having had an SUD without your written consent.7

Misconceptions About MAT

People may have the misconception that MAT means substituting one drug for another. This is not the case; MAT drugs are evidence-based, FDA-approved medications that can normalize physiological functioning, restore balance to previously-disrupted brain chemistry, and block the reward associated with continued substance misuse for those in recovery.1

You also might worry that you’re not sober if you use MAT medications. However, FDA-approved medications used under the discretion of a prescribing physician support recovery and sobriety. These medications are not designed to get you high or contribute to continued, compulsive misuse or addiction. Instead, they are intended to help you sustain recovery progress as your work toward long-term sobriety.1

Some people may have concerns about the potential for misuse of MAT medications themselves. However, while opioid agonist treatment medications may have some abuse liability of their own, their reinforcing properties are limited when used in adherence with a prescribed treatment schedule. Additionally,  medications such as Suboxone (buprenorphine and naloxone) are formulated to deter certain types of misuse because doing so would result in blockade of some of the rewarding or pleasurable effects of the drug. That means if you misuse them, you won’t experience euphoria or get high, but will instead be at risk of experience unpleasant withdrawal symptoms.8

Yet another common misconception about MAT is that there’s no proof that MAT is better than abstinence. However, MAT is evidence-based and recommended as the first line of treatment by the National Institute on Drug Abuse, SAMHSA, National Institute on Alcohol Abuse and Alcoholism, Centers for Disease Control and Prevention, and other organizations.9

Does Insurance Cover MAT Treatments?

Most health insurance plans cover at least a portion of MAT treatment, if not the entirety of MAT treatment. The 2008 Mental Health Parity and Addiction Equity Act states that group health insurance plans are required to provide the same benefits for substance abuse disorders as they do for medical or surgical care.10 Additionally, 31 state Medicaid FFS programs covered methadone maintenance treatment provided in outpatient OTPs as of May 2013; specific Medicaid requirements about buprenorphine can vary by state.9 It’s advisable to consult your insurance provider or plan administrator to verify your specific benefits.

To find out more about whether your insurance may cover rehabilitation or MAT at AAC, use the form below.

How Long Does MAT Last?

Medication assisted treatment durations will vary from one individual to the next, depending on factors such as addiction severity, clinician recommendations, patient wishes, overall health, and the rate of recovery progress. Some individuals may remain on an MAT regimen for years. If at any point a decision is reached between you and your doctor to discontinue treatment, you’ll receive assistance with tapering off the medication when the time is right for you.9

How to Find MAT Treatment Near Me

American Addiction Centers is a leading provider of MAT at our inpatient and outpatient facilities located across the nation. We also specialize in co-occurring disorders treatment and offer individualized treatment plans that are customized to your specific needs. Our expert, compassionate medical staff and team of professional addiction counselors know what you are going through, and they are qualified to provide the best assistance to support you on your path to recovery.

References

  1. Substance Abuse and Mental Health Services Administration. (2021, January 4). Medication-assisted treatment (MAT).
  2. Center for Substance Abuse Treatment. (2012). Medication-assisted treatment for opioid addiction in opioid treatment programs. Treatment improvement protocol (TIP) Series 43. HHS Publication No. (SMA) 12-4214. Rockville, MD: Substance Abuse and Mental Health Services Administration.
  3. Lee, J., Kresina, T. F., Campopiano, M., Lubran, R., & Clark, H. W. (2015). Use of pharmacotherapies in the treatment of alcohol use disorders and opioid dependence in primary care. BioMed research international, 2015, 137020.
  4. Substance Abuse and Mental Health Services Administration. (2020, August 19). MAT medications, counseling, and related conditions.
  5. Substance Abuse and Mental Health Services Administration. (2020). Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health (HHS Publication No. PEP20-07-01-001, NSDUH Series H-55). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.
  6. Substance Abuse and Mental Health Services Administration. (2020). Behavioral Health Barometer: United States, Volume 6: Indicators as measured through the 2019 National Survey on Drug Use and Health and the National Survey of Substance Abuse Treatment Services. HHS Publication No. PEP20-07-02-001. Rockville, MD: Substance Abuse and Mental Health Services Administration.
  7. Substance Abuse and Mental Health Services Administration. (2004). The confidentiality of alcohol and drug abuse patient records regulation and the HIPAA privacy rule: implications for alcohol and substance abuse programs.
  8. The College of Psychiatric and Neurologic Pharmacists. (2016, January). Buprenorphine/naloxone (Suboxone).
  9. National Council for Behavioral Health. (2016). 7 myths about medication assisted treatment (MAT) for opioid use disorder (OUD).
  10. S. Department of Health & Human Services. (2020, September 1). Does insurance cover treatment for opioid addiction?
Last Updated on September 9, 2021
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