MAT combines FDA-approved medications with counseling and behavioral therapy to treat opioid, alcohol, and other substance use disorders. At Carrara, every medication decision is made by a physician, in a house with six clients and a 4:1 staff ratio.
No, and the difference is clinical rather than rhetorical. Addiction is compulsive use despite harm; a stabilized dose of buprenorphine or naltrexone does not impair you, does not escalate, and is not chased. The first goal of treatment is a safe, steady body; the second is staying long enough for therapy to work, and a therapeutic dose serves both. The medication manages the physiology, the withdrawal and the cravings, while therapy does the work medication can’t touch. Neither one is the treatment alone, and for many people on MAT the heaviest side effect is still the stigma.
Medication plus therapy, run together. The evidence base is strongest for opioid and alcohol use disorders.
Substitution. A person stabilized on the right medication at the right dose isn’t impaired and isn’t chasing anything; that’s the clinical difference between a prescription and a habit.
Decided clinically, at evaluation, not by preference or ideology. Some people need it, some don’t, and both answers are respectable here.
What each one does, and the side effects that come with it, in one place. Which one fits, if any, is a clinical decision made at evaluation, weighed benefit against side effect with you in the room.
A partial opioid agonist: it occupies the receptors enough to stop withdrawal and craving without the high, and it is the backbone of modern opioid MAT. Common side effects are constipation, headache and disturbed sleep early on, and most settle as the dose stabilizes.
A full agonist with decades of evidence, dispensed under the tightest federal structure of the three. Sedation and constipation are the common side effects, and its interactions demand respect, which is part of why that structure exists. Whether and where it fits is answered at evaluation.
The opposite approach: a blocker, so there is nothing to chase. It comes as a daily pill or a monthly injection and is also approved for alcohol use disorder. Nausea is common early, and it cannot start until opioids have fully cleared, or it triggers withdrawal at once.
Opioid medications can slow breathing at high doses, which is why respiratory depression is screened for, and mixing them with alcohol or benzodiazepines is the combination the team watches hardest, the same danger behind mixing Xanax and alcohol. Every client and family learns the signs of an overdose and how naloxone works.
Report everything, adjust early, never tough it out in silence. Side effects are data, and the plan moves when they do. MAT medications also interact with surgical sedation, so any procedure is planned in advance.
MAT here is one thread of residential treatment in the same Malibu beach house where detox happened, with the same clinicians and one plan. Four steps, and a person responsible at each one.
Medication decisions sit with the medical team under Dr. Kenneth Spielvogel, MD, Senior Medical Officer, a physician nearly thirty years into clinical practice, working inside the medical program Dr. Craig V. Smith, MD, directs. What’s indicated, what isn’t, and why, decided person by person.
Where indicated, medication starts during managed withdrawal, with vitals and symptoms watched as the dose is set, which is what makes fentanyl and alcohol detox bearable and safe.
Doses are adjusted as the body steadies, alongside counseling and group work, inside a program of up to 80 hours of individual 1-on-1 points of client contact per month. Where chronic pain is part of the picture, MAT is coordinated with pain management.
Coming off the medication is itself a managed, gradual step, and staying on longer is a legitimate clinical outcome, not a failure. Nobody is weaned by the calendar.
Medication buys the quiet. Therapy is what the quiet is for. Carrara Treatment, Malibu
Methadone is one of the three approved medications, and its dispensing is federally structured. Whether it fits your situation, and how it would be coordinated, is an evaluation conversation with the medical team rather than a checkbox on a website.
As long as it’s doing its job, and not a day past that by ideology in either direction. Tapering is a managed step when it happens; staying on is a legitimate outcome when it’s working. The calendar doesn’t decide.
Yes, and it matters more there than anywhere, because fentanyl’s withdrawal runs long and medication support is what makes it manageable. The fentanyl page covers the whole exit. If you want to ask about medication before anything else, admissions can be reached at (888) 383-5207.
If you’re weighing MAT, you probably have questions you haven’t said out loud: about dependence, about what your family will think, about coming off it one day. Ask them. The call is confidential, the person who answers is Carrara’s own admissions team, and if this isn’t the right place, we’ll say so and point you somewhere that is.
If this is an emergency, call 911. For free confidential support 24 hours a day, call or text 988.
This page is general information, not medical advice.
