What is MAT?

People who struggle with substance use disorders often find it very difficult to stop and abstain without help. The process of going from intoxication to abuse to dependence is unique to each individual making the subsequent treatment equally diverse. The use of medication to help people with substance use disorders is not new and has evolved into the standard of treatment for issues like opioid use disorder (OUD). It is not, however, a silver bullet and requires a whole-patient approach including counseling and behavioral therapies.

Before digging in, let’s take a look at the various substances which when abused may become a substance use disorder (SUD):

(Addiction Policy Forum, 2020)

All of the above can be used, abused, and become the driving substance(s) behind a disorder(s). Our next order of business is determining what constitutes a substance disorder. For some, the very act of using an illicit substance like heroin, cocaine, methamphetamine etc. is enough to diagnose a problem. The fact is, using the previous substances is only a potential legal problem to begin with, they become disorders when at least two of the following symptoms are met within a 12-month period:

  • Loss of control over drug/alcohol use
  • Investing large amounts of time obtaining substances
  • Cravings
  • Continued use in spite of relationship conflicts
  • Risk-taking, such as using while driving
  • Continued use in the face of developing health problems
  • Increasing tolerance levels
  • Loss of interest in activities once enjoyed
  • Withdrawal episodes
  • Failed attempts to stop using
  • Failing to meet obligations (work, home, school)

(American Psychiatric Association, 2013)

Remember, this is for informational purposes only and not meant to replace a proper clinical diagnosis by a professional.

Next we’ll look at the different medications used in MAT:

Opioid Use Disorder (OUD)

Buprenorphine; an opioid used to treat OUD, acute and chronic pain. It comes in tablet (generic) and long-lasting injectable forms (Sublocade®). This form of medication is often prescribed to women with an OUD during pregnancy and while breastfeeding.

Buprenorphine/Naloxone; a partial opioid agonist meaning it helps avert withdrawal while the naloxone is an antagonist or “blocker” helping prevent the effects of other opioids like heroin, fentanyl, oxycodone (OxyContin® or Percocet) hydrocodone (Vicodin®), etc. These two drugs work together to aid in recovery efforts. Common brand names are Suboxone® and Zubsolv®.

Naltrexone; This medication can come in oral tablets and long lasting injectable. Naltrexone is non-habit forming and is an antagonist meaning it blocks the brain receptors from accepting opioids The common brand name is Vivitrol®.

Alcohol Use Disorder (AUD)

Naltrexone; This medication can come in oral tablets and long lasting injectable. Naltrexone is non-habit forming and is an antagonist meaning it blocks the brain receptors from accepting opioids The common brand name is Vivitrol®.

Acamprosate; It is an oral tablet helping people with AUD maintain abstinence from alcohol by alleviating some negative symptoms of prolonged abstinence, taken three times per day. Brand name Campral® EC.

Disulfiram; An oral tablet that causes unpleasant symptoms such as nausea and flushing of the skin after consuming alcohol. Wanting to avoid those unpleasant effects can help some people refrain from drinking. Brand name Antabuse.

Nicotine Use Disorder (NUD)

Bupropion; A non-nicotine aid helping to quit smoking and tobacco use by reducing withdrawal symptoms. Brand name, Wellbutrin.

Varenicline; An oral medication used to reduce cravings. Brand name, Chantix.

The previous two medication used together with nicotine gum and behavioral therapy greatly increases the likelihood of success in quitting and abstaining from tobacco/nicotine products.

 

Currently, there are no FDA approved medications for stimulant use disorder (cocaine and methamphetamine) or sedatives like alprazolam (Xanax) or clonazepam (Klonopin); although, behavioral therapy is quite effective.

Ultimately, different medications used for the treatment of SUDs are helpful and can certainly be used as an effective entryway into recovery. There can be no sustainable recovery from either substance or circumstance without addressing the thinking problem associated with them. Understanding first that there is a problem, become willing to change negative behaviors, then trusting in a power greater than oneself is the most effective way to achieve the goal of wellness and restoration of the human spirit.

References:

Addiction Policy Forum. (2020, September 12). Types of Substance Use Disorders. Retrieved from https://www.addictionpolicy.org/post/types-of-substance-use-disorders.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596.