Medication-Assisted Treatment

Meridian Advanced Psychiatry often uses Medication-Assisted Treatment (MAT) as part of our program. MAT utilizes medications, such as buprenorphine and naltrexone to stabilize brain chemistry, to block the euphoric effects of opioids, relieve physiological cravings, and normalize body functions. Numerous studies have shown that MAT decreases opioid use, opioid-related overdose deaths, criminal activity, and infectious disease transmission. Patients treated with medication were more likely to remain in therapy compared to patients receiving treatment that did not include medication.

MYTH

Medication–assisted treatment “substitutes one addiction for another.”

FACT

When properly prescribed, addiction medications reduce drug cravings and prevent relapse without causing a high. Buprenorphine is a partial opioid and results in physical dependence, but is fundamentally different from short-acting opioids such as heroin and prescription painkillers. Short acting opioids cause significant sedation, euphoria, dependence, and tolerance. Buprenorphine reduces all of these risks and helps patients disengage from drug seeking and related criminal behavior and become more receptive to behavioral treatments. Injectable naltrexone is not opioid-based and does not result in physical dependence.

MYTH

MAT is a crutch that prevents “true recovery.”

FACT

Individuals stabilized on MAT can achieve “true recovery,” according to leading addiction professionals and researchers. This is because such individuals do not use illicit drugs, do not experience euphoria, sedation, or other functional impairments, and do not meet diagnostic criteria for addiction, such as loss of volitional control over drug use. MAT consists not only of medication but also of behavioral interventions like counseling. The medication normalizes brain chemistry so individuals can focus on counseling and participate in behavioral interventions necessary to enter and sustain recovery.

MYTH

MAT should not be long term.

FACT

There is no one-size-fits-all duration for medication-assisted treatment. The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends a “phased approach,” beginning with stabilization (withdrawal management, assessment, medication induction, and psychosocial counseling), and moving to a middle phase that emphasizes medication maintenance and deeper work in counseling. The third phase is “ongoing rehabilitation,” when the patient and provider can choose to taper off medication or pursue longer-term maintenance, depending on the patient’s needs. For some patients, MAT could be indefinite. The National Institute on Drug Abuse (NIDA) describes addiction medications as an “essential component of an ongoing treatment plan” to enable individuals to take control of their health and their lives. Typically, a patient should consider 12 months the minimum treatment to allow the brain to heal and normalize.

MYTH

Requiring people to taper off MAT helps them get healthy faster.

FACT

Requiring people to stop taking their addiction medications is counter-productive and increases the risk of relapse. Because tolerance to opioids fades rapidly, one episode of opioid misuse after detoxification can result in life-threatening or deadly overdose.