For many counselors who are engaged in clinical practice, there can be moments when a new concept, practice, or therapeutic intervention is introduced that requires comprehension in order to be successfully applied to clients. Regardless of how the information is obtained, the desired outcome is to achieve positive therapeutic outcomes for clients. A notable intervention that has garnered significant attention over the years even though it dates back to the early 1800s is Medication Assisted Treatment (MAT) and its use with opioid use disorder (OUD). The MAT program was formally established in the United States in 1930 as a means of targeting individuals who presented with heroin addiction through the use of methadone. According to the United States Health and Human Services it is reported that around 9.2 million people who are 12 years of age and older misused opioids in the last year. Currently, there are roughly 6.7 to 7.6 million adults in the United States who are living with OUD.
What is Medication Assisted Treatment (MAT)?
Medication Assisted Treatment (MAT) is considered to be the use of medications, counseling, and available behavioral therapies to treat OUD and seeks to help people achieve sustained recovery efforts. The use of MAT has become well known when it comes to the treatment of addictive disorders, particularly working with and treating Opioid Use Disorder. It is reported that more than 20% of 21 million individuals that are impacted by drugs and/or alcohol can receive MAT as a part of their treatment regimen. A key element that has propelled the use of MAT is that it is an evidence-based practice that works to combine pharmacology, counseling, and social support to achieve management of an ailment. More and more healthcare professionals are receiving training in this area of addiction and the use of MAT is at the frontier of this evolution. The therapeutic interventions that are a part of MAT work to achieve balanced brain chemistry, block the euphoric effects of opioids and alcohol, manage physiological cravings, and normalize body functions without producing significant negative effects.
How does Medication Assisted Treatment (MAT) work?
The use of MAT is tailored to target various aspects of addiction that can include physical, psychological, social, behavioral, and spiritual elements. There is a holistic approach that can be adopted to manage the different aspects of a person’s OUD. It is through the process of targeting the brain’s chemistry of addiction that MAT can assist to decrease cravings and withdrawal symptoms. In addition, it can enable gradual tapering of opioid use for a more gentle withdrawal process and decrease the chances of relapse. The benefits that can be associated with the use of MAT can also include improving mental health, reducing illicit opioid use and preventing opioid overdose.
Medication Approvals by Food and Drug Administration (FDA)
As it currently stands, the FDA has given approval to the following medications for MAT with certain medications being particularly used for OUD
- Methadone: A long acting opioid that helps achieve stability from the ups and downs of heroin or other opioids.
- Buprenorphine: A Partial opioid agonist that can decrease opioid cravings.
- Naltrexone: An opioid antagonist that blocks the euphoric effects of opioids and decrease the chances of relapse
- Naloxone (Narcan): An opioid antagonist that temporarily reverses the effects of opioid overdose.
- Disulfiram: Produces an unpleasant reaction when alcohol is consumed.
- Acamprosate: Helps to balance the brain’s chemistry when it is disrupted by alcohol use and reduces cravings for alcohol.
In addition, there are other medications that are used to treat drug addiction that are not approved by the FDA but may be used off label for the management of other symptoms. These drug classes can include antipsychotics, anticonvulsants, beta-blockers, and clonidine.
Non-pharmacological treatments of OUD
The use of MAT can be combined with psychotherapy and other interventions that include cognitive behavioral therapy, group therapy, behavioral therapy, and family counseling. Other aspects of the treatment can include drug courts and medication counseling, which is a brief individual consultation on medication adherence lasting less than 20 minutes.
Is MAT Effective?
It is reported that MAT’s treatment approaches are effective in helping people to tackle substance use disorders, substantial research is in place to support this claim. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), MAT is shown to significantly reduce the need for inpatient detoxification, which can help to minimize costs that clients may incur during this process. Additionally, deaths that can be associated with opioid overdoses can be reduced with treatment such as buprenorphine, naloxone. Even though there is currently substantial evidence to support the efficacy of MAT there are still gaps to address the treatment of all types of addiction.
Over the years the use of MAT has been shown to save a number of lives that might otherwise have been lost to the ravages of addiction. MAT adopts an evidence-based approach that yields a number of therapeutic and social benefits for individuals who agree to the associated interventions. The ability of MAT to help reduce relapse rates and achieve sobriety from OUD and other substances is one of the primary reasons that it continues to gain favor in the medical and scientific community.
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Department of Mental Health & Substance Abuse Services.(2023). Medication assisted treatment. https://www.tn.gov/behavioral-health/substance-abuse-services/treatment---recovery/treatment---recovery/opioid-treatment-programs.html
Deyo-Svendsen, M., Cabrera Svendsen, M., Walker, J., Hodges, A., Oldfather, R., & Mansukhani, M. P. (2020). Medication-assisted treatment for opioid use disorder in a rural family medicine practice. Journal of Primary Care & Community Health, 11, 2150132720931720. https://doi.org/10.1177/215013...
Food and Drug Administration. (2023). Information about medication-assisted treatment(MAT). https://www.fda.gov/drugs/information-drug-class/information-about-medication-assisted-treatment-mat
Ghanem, N., Dromgoole, D., Hussein, A., & Jermyn, R. T. (2022). Review of medication-assisted treatment for opioid use disorder. Journal of Osteopathic Medicine, 122(7), 367–374. https://doi.org/10.1515/jom-2021-0163