Medication Assisted Treatment

MAT isn’t a cure for addiction, but it’s an effective tool in the process - to push forward and support recovery. For example, in treating opioid use disorders, the medicine binds to opioid receptors in the brain to activate them. They essentially mimic the actions of opioids on the brain to a slightly lesser extent.

By binding to these receptors, the medicine completely blocks the receptors that cause euphoric feelings when you take opioids. Ultimately, if you retake the drugs, you won’t feel as pleasant and will be more motivated to stay away from them. 

In combination with the medication, you can access therapeutic techniques such as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and contingency management. 

Importantly, these treatments ensure you’ll gain an understanding of the thoughts and emotions that trigger your drug use. You’ll also be taught skills to cope with distress and temptation, helping to prevent relapse.

Cognitive Behavioral Therapy (CBT)

CBT is a technique of talk therapy that helps you identify, understand and ultimately change the thoughts and behaviors that contribute to your addiction. The therapy is provided by a licensed therapist, usually in individual sessions. You can expect to go through a program for about twelve weeks to get the best out of CBT. 

With CBT, you can learn how to: 

• Identify your triggers

• Manage your emotions

• Deal with stressful situations in a healthier way

• Make the most out of your recovery process

• Resist the urge to relapse

Dialectical Behavior Therapy (DBT)

DBT is another type of talk therapy based on CBT and is intended to help people who experience their emotions very intensely. The goal is to help you understand how your thoughts affect your emotions and behaviors. 

DBT works well in addiction treatment because it focuses on teaching someone to accept their reality and unhelpful behaviors while teaching them how to regulate their emotions. This method helps those who have intense emotions and addictive tendencies to cope with them in a much healthier way instead of denying them entirely. 

Alcohol and opioid addiction treatment utilizes DBT because it improves the emotions that lead to that use. Additionally, it can help improve your overall mental health and quality of life. 

Contingency Management

Contingency management is a behavioral therapy used to treat a wide range of substance use disorders. The treatment uses positive reinforcement - a reward - to encourage someone to avoid using drugs. 

The goal is to give you concrete motivation to stay on track with your treatment and try your best not to relapse. However, contingency management is best when combined with other therapies - CBT or DBT. 

Because medication-assisted treatment takes a holistic approach, it’s a coordinated treatment that aims to ensure all your physical and psychological needs are met. It doesn’t matter whether you’re getting inpatient or outpatient treatment. A great treatment facility will provide a full team to ensure a successful recovery. 

This team includes:

• A Case Manager - to ensure your treatment is personalized to your situation

• Addiction Medicine Doctor

• Nurse

• Licensed Therapist

As opioid dependence differs from person to person, different medications work effectively to treat each case. The same goes for alcohol addiction since the levels of dependence and its effects on the body differ from person to person.

Opioid Dependency Medications

Three medications are currently FDA-approved for assisting with opioids - methadone, buprenorphine, and naltrexone. They all work to ease withdrawal symptoms and block any euphoric effects of opioids. 

• Methadone: This medicine has been a reliable treatment for opioid dependence since the 1960s. It works by reducing cravings for the drug and significantly minimizing withdrawal symptoms. This is because it mimics an opioid, making the brain think it has received an opioid dose. In treatment, the clients who receive methadone can only take it while under a doctor's supervision. Additionally, it can only be dispensed specifically through an opioid treatment program. 

• Buprenorphine: This medicine is most helpful in eliminating uncomfortable withdrawal symptoms that come with stopping opioid misuse. Unlike methadone, buprenorphine can be prescribed by certified healthcare providers in clinics or community hospitals. 

The medicine can be administered as tablets, injections, or patches. These safe, prescribed options are great for avoiding stealing or further misuse of medication. 

• Naltrexone: This is different from both methadone and buprenorphine. Naltrexone is an opioid antagonist. This means its job is to block opioid receptors and prevent their euphoric effects. It can also help to reduce cravings, but it should only be introduced into MAT programs seven to ten days after a supervised drug detox program has been completed. 

Naltrexone can be prescribed as a daily oral dose or a long-acting injection once a month. The latter option is often the most effective. However, patients should be aware of a high overdose risk if they retake opioids after finishing this medication. 

Opioid Overdose Prevention Medication

Naloxone is a life-saving medication that helps prevent an opioid overdose by quickly reversing the detrimental effects of the overdose. It comes in a nasal spray and injectable form. To work, it has to be given in time, and it can restore normal breathing within two to three minutes of being administered. However, if the overdose results from fentanyl, a medical professional may need to administer a higher dose.

Alcohol Use Disorder Medications

• Acamprosate (Campral): This is a medicine that helps with alcohol abuse recovery by reducing cravings. It doesn’t completely prevent withdrawal, but it helps to minimize the uncomfortable symptoms. 

• Disulfiram (Antabuse): This medication works by making you feel very sick when you take alcohol. You can feel reactions such as nausea, stomach ache, fatigue, and headaches. The goal is to help associate alcohol with these negative feelings so that you are unlikely to relapse. 

• Naltrexone (Vivitrol or Revia): Similarly, in opioid abuse treatment, it blocks the pleasurable effects of alcohol and suppresses any cravings.

Nicotine Use Medications

• Nicotine-replacement therapies (NRTs): This is nicotine in the form of patches, gum, inhalers, sprays, or lozenges. This is to stop the tendency to smoke. This treatment helps relieve some symptoms of withdrawal so that a person can focus on the emotional aspects of quitting. 

• Varenicline (Chantix or Tyrvaya): This medicine helps to reduce nicotine cravings because it acts on the same brain receptors as nicotine. People often take this treatment for about twelve weeks. 

• Bupropion (Wellbutrin or Zyban): This was initially developed for depression treatment but also helps people stop smoking. It works by stimulating dopamine and norepinephrine in the brain, thus reducing nicotine cravings.