Exploring Medication-Assisted Treatment (MAT) for Substance Use Disorders

It’s been six years since the U.S. Department of Health and Human Services declared opioid misuse a national epidemic. Over a decade has passed since opiates were prescribed freely with little consideration for their addictive potential. Despite the passage of time, horrific stories of abuse, overdose and death still dominate the news as a result of the devastation of primarily Fentanyl, as well as other opiates. In the ongoing battle against substance use disorders, including opioid addiction, one of the most effective strategies emerging in the healthcare landscape is Medication-Assisted Treatment (MAT). MAT combines medications with counseling and behavioral therapies to treat substance use disorders, providing a multi-pronged approach to the treatment of addiction. MAT has been shown to improve patient survival, increase retention in treatment, and decrease illicit opiate use and other criminal activity among people with substance use disorders. Understanding MAT MAT is primarily used to treat addiction to opioids such as Heroin, Fentanyl, and even prescription pain relievers that contain opiates. The prescribed medications operate to normalize brain chemistry, block the euphoric effects of alcohol and opioids, relieve physiological cravings, and stabilize body functions without the negative effects of the abused drug. The cornerstone medications used in MAT for opioid dependency include Methadone, Buprenorphine, and Naltrexone. Each of these medications works differently to address withdrawal symptoms and psychological cravings, serving as a safe and controlled level of medication to overcome the use of an abused opioid. Methadone Methadone is a long-acting opioid agonist that reduces craving for and use of opioids. It is dispensed daily in specialized clinics, and patients are closely monitored by healthcare professionals to ensure the safety and effectiveness of the treatment. Buprenorphine Buprenorphine is a partial opioid agonist that, like methadone, helps relieve drug cravings without producing the same high as other opioids. Its unique pharmacological properties make it possible to be prescribed and dispensed in physician offices, significantly increasing the accessibility of treatment for many patients. Naltrexone Naltrexone is an opioid antagonist that blocks the effects of opioids at their receptor sites in the brain and is used once a patient has been detoxified. It is available in a pill form or as an injectable. The injectable form is administered once a month, offering a convenient option for individuals who struggle with adherence to daily medications. The Role of Counseling and Behavioral Therapies While medications can significantly manage the physical aspects of addiction, counseling and behavioral therapies are essential components of MAT, addressing the mental and emotional aspects. These therapies can help individuals understand the root causes of their addiction, develop coping strategies to deal with the stressors and triggers that may lead to relapse, and integrate healthy habits into their lives.  The Effectiveness of MAT Evidence indicates that MAT significantly increases the odds of successful recovery compared to non-medication approaches. The integration of medications and therapy in MAT allows for a more holistic approach to treating substance use disorders, which can lead to improved outcomes, such as reduced risk of overdose and better social functioning. Despite its proven effectiveness, MAT is underutilized, often due to stigma, lack of access to qualified providers, and misconceptions about substituting one drug for another. Expanding access to MAT and educating healthcare providers, patients, and the public about its benefits can help destigmatize this treatment method and offer hope to those struggling with addiction. Conclusion Decades into the deadliest drug overdose epidemic in American history, people are dying at higher rates than ever. The epidemic is far from over. Between 2017 and 2021, the number of overdose deaths involving opioids jumped from 47,600 to 80,411 — many more Americans than are killed each year by guns or cars. The surge has been largely driven by powerful synthetics like fentanyl, but other newer threats lurk on the horizon. Medication-Assisted Treatment represents a critical strategy in the continuum of care for individuals with substance use disorders. By combining FDA-approved medications with comprehensive counseling and therapy, MAT addresses the whole person, not just the addiction. As healthcare providers and society embrace MAT, it holds the promise of transforming lives and offering a pathway to recovery for those trapped in the cycle of addiction.