Answering Questions about Medication-Assisted Treatment

Recently, there has been a debate over the use of medication-assisted treatment (MAT) in fighting addiction.  Some believe that replacing opioids with different opioids is more harmful than helpful, while others may not fully understand the benefits or negatives of MAT.  An article published by STAT examines the subject in great detail.  Here are 5 things you should know:

How Does It Work?

Opiates activate receptors in the brain that release neurotransmitters and produce the high. Doctors give opiates that target those same receptors but take longer to be absorbed into the blood so they are no longer associated with the high.  They can also prescribe a non-opioid drug that blocks the receptors so no high is produced if the opioid is taken again.

What’s the Difference?

Medication-assisted treatment replaces a dangerous drug with a drug that has been proven to help stabilize a patient so they can return to work and functionality.

Where’s the Evidence?

Several studies published by the American Psychological Association and other medical journals have found that these drugs are effective in decreasing relapse, preventing infectious diseases, and preventing overdoses. Further analysis can be found here.

Who Is It For?

While this type of treatment is beneficial for the general population, it is not for everyone and not every drug is for everyone.  One gap in the research is that there is no study weighing the benefits of each drug. 

As stated in the article, “Each drug does carry different risks and benefits. People can overdose and die on methadone, whereas they can’t with buprenorphine or naltrexone. Buprenorphine and naltrexone can be taken orally; naltrexone also comes in an injectable form. And people who need surgery can be taken off buprenorphine more quickly than they could be if they took methadone.”  Doctors should consult with patients on the right fit.

What About Therapy?

When it comes to therapy and MAT, a combination is usually the best fit.  Medication has been shown to produce good results without psychotherapy but a well-rounded combination is the most beneficial.  

Dr. Stuart Gitlow, past president of the American Society of Addiction Medicine said, “For every major, chronic, life-threatening disease, there’s always a combination of therapeutic modalities that are used. For instance, in hypertension, we tell people to exercise and lose weight and quit smoking and don’t eat salt in their diet and by the way, take this antihypertensive [drug].  For opioid use disorder, it’s really the same thing.”