doctor prescribing medication assisted treatment

Medically assisted treatment is effective for many people because it combines the use of approved medications to counteract alcohol cravings, address symptoms associated with withdrawals, and address the underlying biology of withdrawal with behavioral therapy that helps the patient unlearn their unhealthy or unhelpful thinking patterns and develop personal coping strategies.

MAT provides time for an individual’s brain to adjust to life without alcohol. Medications are tailored to meet each individual’s recovery needs and withdrawal symptoms so that they can reintegrate with their daily responsibilities and activities more easily.

Other benefits of MAT include:

  • Lowered relapse rate
  • Increased retention in treatment programs
  • Decreased alcohol use
  • Lowered risk of incarceration and legal troubles
  • Increased ability to gain and maintain a job
  • Improved birth outcomes among females with alcohol use disorder who may be pregnant

Medically assisted treatment is also viewed by many as a way for people to bridge the gap between their life as a person in active addiction and life as a person in recovery. MAT helps the individual feel stronger while they learn how to change their behavior and develop healthier coping mechanisms.


Types of Medically Assisted Treatment for Alcohol Use Disorder

At Lasting Recovery, our board-certified medical director personally oversees the administration of medical interventions. Not all clients will be eligible for MAT, and not all medications will be appropriate for every person. We carefully screen and manage all clients who take part in MAT to ensure that their medication regimen is appropriate, safe, and effective.

Some of the medications we use include:

Medication to make drinking less pleasurable. Naltrexone is a prescription medication that blocks the brain’s opioid receptors, reducing the surge in dopamine and other neurotransmitters that a person experiences when they drink. As a result, an individual may be less likely to drink, as they will no longer experience the pleasurable effects of alcohol. Additionally, research indicates that naltrexone can help reduce cravings for alcohol, making it less likely that a person will relapse.

Medication to cause a reaction to alcohol. The prescription medication disulfiram, also known as Antabuse, causes individuals to feel nauseous or ill when consuming alcohol. The medication works by blocking the body’s ability to process alcohol and convert it into chemicals that affect the brain. When used as part of a professional treatment regimen, Antabuse can help discourage individuals from drinking. At Lasting Recovery, we only use Antabuse for individuals who have severe forms of alcohol use disorder.

Medication to manage cravings. The FDA-approved drug Campral can help individuals who are in recovery from alcohol use disorder manage cravings to drink. The drug works by lessening withdrawal symptoms for individuals who are in long-term recovery, including reducing anxiety, improving sleep. At Lasting Recovery, we typically prescribe Campral only when an individual does not respond well to naltrexone.

How Naltrexone Can Help Recovery From Alcohol Use Disorder

One of the most popular medications used in MAT for alcohol use disorder is naltrexone. As mentioned above, naltrexone blocks the pleasurable effects of alcohol and may reduce an individual’s cravings to drink.

Naltrexone can reduce those cravings in many individuals by blocking the effect that alcohol has on the brain. As a result, individuals no longer receive the dopamine “high” associated with alcohol consumption and are less likely to experience a sense of pleasure when drinking or cravings when they stop drinking.

Scientists believe that naltrexone is effective in helping individuals manage their recovery from alcohol use disorder thanks to a series of comprehensive research studies. One study of more than 1000 participants found that naltrexone increased the number of days individuals did not drink. Other studies have since found that naltrexone contributed to an approximately 25% reduction in the number of days when individuals drank heavily. Studies continue to understand precisely how effective naltrexone is across different groups, backgrounds, and levels of alcohol consumption.

Naltrexone isn’t a “one size fits all” treatment for alcohol use, however. Individuals taking naltrexone may be able to reduce their cravings and their likelihood of drinking but shouldn’t rely on the medication alone to stop their drinking. Instead, naltrexone is most effective when combined with behavioral therapy, including forms of talk therapy like Cognitive Behavioral Therapy (CBT) or Dialectical Behavior Therapy (DBT).

If you think you or a loved one might have a problem with alcohol abuse take our brief self-assessment to find out if it is time to seek help.

Myths about Medically Assisted Treatment

Despite numerous studies that have shown how effective MAT can be for those trying to overcome an alcohol addiction, many misconceptions and myths still exist about this treatment option.

For instance, some view the treatment as substituting one addiction for another. The reality is that when naltrexone is used as prescribed, the drug can reduce the craving for alcohol without substituting another addictive substance. This reduces the person’s chance of a relapse. Drugs like naltrexone also do not create the sedative effect on the brain that alcohol does, allowing the individual to keep a “clear head” and engage in additional therapy to deal with their addiction.

Another myth is that MAT is only a “temporary fix” and doesn’t allow people to achieve a true recovery from alcohol. Because naltrexone blocks the body from experiencing an alcohol-induced dopamine surge, the drug can greatly support behavioral therapy. What’s more, by minimizing the likelihood of returning to alcohol use, the person can then benefit from professional treatment to a greater degree.

Some believe that MAT should not be used in the long term. SAMHSA advises a phased approach to alcohol treatment with MAT.

  • This means beginning with a period of stabilization, where the person works on withdrawal management as well as psychosocial counseling while starting the medication.
  • The middle phase should be focused on maintaining the individual’s medication routine while working more deeply on counseling.
  • Finally, individuals will enter the third phase of ongoing rehabilitation. During this period, the patient and their health care provider may choose to taper off the medication or continue its usage for long-term maintenance. There is no one-size-fits-all approach when it comes to MAT.

Is Medically Assisted Treatment Appropriate for Opioid Addiction?

doctor prescribing medication for opioid addictionThe opioid crisis continues to ravage the lives of many Americans, with overdoses involving opioids killing almost 50,000 people in 2019, according to the Centers for Disease Control and Prevention (CDC). Additionally, the National Institute on Drug Abuse (NIDA) estimates that 21 to 29% of individuals who are prescribed opioids for chronic pain will misuse the medication.

The most effective treatment currently available to overcome addiction to opioids is a combination of counseling and behavioral therapy alongside medication. The use of pharmaceutical medications to treat addiction is known as medication-assisted treatment, or MAT, and has been approved by the Food and Drug Administration (FDA). MAT programs are tailored to meet each patient’s needs within a clinically driven environment. MAT has been shown to save lives in people with opiate use disorders and is therefore standard-of-care for opiate use disorders.

The FDA-approved drugs used to treat opiate use disorders are buprenorphine (brand names include Suboxone), methadone, and naltrexone (which comes in oral and long-acting injectable form). Naloxone is approved for treating opiate overdose. While these medications can be helpful in combatting opioid use disorders, helping some sustain their recovery, not every addiction treatment program uses these medications interchangeably. At Lasting Recovery, we incorporate buprenorphine and the oral and injectable form of naltrexone into treatment plans for clients struggling with opioid use disorder when appropriate. Below, we review these different treatments in more detail.

Types of MAT Medications for Opioid Use Disorder

Medical professionals often prescribe Buprenorphine (brand names include Suboxone) to individuals with opioid use disorder. The drug has been shown to be effective in increasing the chance that someone with opioid use disorder will remain in treatment. It also reduces withdrawal and cravings. This medication can be used for months, years, or even a lifetime safely.

Buprenorphine was first approved by the FDA in 2002 and can be prescribed or dispensed in physician offices. The medication must be administered under the supervision of a licensed medical practitioner.

Another medical treatment for opiate use disorder that we use at Lasting Recovery is naltrexone, orally and injectable. The FDA approved naltrexone for both opioid use disorder and alcohol use disorder as a part of a MAT program. Naltrexone blocks opioid receptors by binding to them and reducing the person’s opioid cravings. It also blocks any reinforcement if a person has a brief return to use.

Unlike the other two MAT drugs, which are used to treat opioid use disorder, naloxone is used to reverse an opioid overdose. It is an opioid blocker medication that can be administered in several ways: into the nose via an intranasal spray, into the muscle or under the skin, or with an intravenous injection. It is recommended that any family member of a person with an opiate use disorder have access to naloxone, as it can save a life if there is a dangerous opiate-related situation.

If you believe you or a loved one might be struggling with an addiction to opioids our brief self-assessment can help you find out.

Is MAT Appropriate for Other Disorders?

road to recovery written outWhile MAT is most commonly used to help individuals recover from alcohol and opioid use disorder, our team at Lasting Recovery may recommend medication for other kinds of problems, as well. In addition to the abovementioned medications, antidepressants, non-habit-forming medications for anxiety and insomnia, and at times, mood-stabilizing medications may be appropriate for individuals who are in treatment. These are discussed below.

Other types of medical treatment that might be used at Lasting Recovery include:

Medication to manage anxiety. For individuals with anxiety disorders, the medications gabapentin and pregabalin are often effective. Originally developed to help individuals manage seizure disorders, these two medications can help reduce some symptoms of social and generalized anxiety, as well as help individuals with an alcohol use disorder stabilize.

Medication to manage depression. Individuals who attend group therapy at Lasting Recovery for depression may also benefit from antidepressants prescribed under the supervision of our medical team. There are many different types of antidepressants with a range of different side effects, so the Lasting Recovery team will ensure clients are matched with the right medication for their needs. Not all clients seeking treatment for depression will be good candidates for antidepressant medication, but an evaluation is always warranted if the depression is moderate to severe, impactful, and longstanding.

In summary, in conjunction with behavioral therapy and support, medical evaluation and MAT is a highly effective part of a comprehensive treatment program for individuals with substance use and mental health disorders.

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