Medication-Assisted Treatment: Pros and Cons of MAT for Recovery
The crisis of opioid addiction has received a great deal of attention as both the magnitude of the problem and the number of fatal opioid overdose numbers have increased dramatically in recent years, whether the start was in the form of prescription drugs or illicit drugs. A multi-pronged approach to address the national crisis has included educating physicians, regulating prescription pain relievers, challenging pharmaceutical companies, and expanding access to Narcan® (naloxone), an opioid antagonist that can reverse overdoses. Medication-assisted treatment is a highly effective tool in the arsenal against substance abuse.
In terms of helping individuals suffering from opioid use disorder, one evidence-based treatment practice has risen to the top. Medication-assisted treatment (MAT) has gained recognition as a particularly effective method of addressing opioid addiction and other types of substance use disorder. Most commonly used for treatment of opioid use and alcohol addiction, MAT has some significant advantages. But it requires strict supervision and may not be for everyone. Before deciding if this intervention can help you achieve your sobriety goals, it is important to consider the medication-assisted treatment pros and cons to determine if it sounds like a good fit for you.
Understanding the Dangers Associated with Opioids
Naturally occurring opioids, including morphine, codeine, and heroin, come from the opium poppy plant. Synthetic opioids, like methadone, fentanyl, carfentanil, and tramadol, are created in a lab. Semisynthetic opioids include oxycodone, oxymorphone, and hydrocodone. These drugs have a powerful sedating and pain-relieving effect, but they also have tremendous potential for physical and psychological dependence. It is estimated that over 2 million people in the US are dealing with an opioid use disorder.
Whether the addictive substance is a prescription pain pill or an illegal street drug, the effects are strikingly similar. Besides being highly addictive, legal and illegal opioids present significant risks for users. There is a severe risk of overdose, which can depress respiratory drive and slow or stop breathing. There are risks associated with seeking drugs and sharing needles, and there are dangers from additives in street drugs.
Pros and Cons of Medication-Assisted Treatment
The Benefits of MAT Treatment for Substance Abuse
Medication-assisted treatment involves the use of medications, in combination with counseling and behavioral therapy. It has become the therapy of choice for many suffering from substance use disorders, especially opioid dependence. This evidence-based approach to treatment is strongly endorsed as an effective treatment modality by the American Medical Association, the National Institutes of Health, and other agencies dedicated to public health care.
The prescribed medication would work in terms of brain chemistry by blocking the euphoric effects of the drugs used, to reduce physical and psychological cravings and normalize the body chemistry over time. As a treatment of opioid use, as well as substance use disorder treatment, it has evolved since the 1950’s when treatment with methadone was first used for heroin addiction. Opioid treatment programs are now equipped with better knowledge of opioid addiction treatment as well as drug addiction overall with the crucial help of MAT.
Medication-assisted treatment for addiction offers these benefits:
- Facilitates safer withdrawal by relieving symptoms and controlling cravings
- Reduces the risk of death due to overdose
- Increases retention in treatment with safer, controlled medications
- Decreases illegal drug use and, with it, the potential dangers and legal consequences
- Prevents relapse when integrated with counseling and behavioral therapies
The Possible Drawbacks of Medication-Assisted Treatment
Though medication-assisted treatment is preferred by many addiction medicine specialists, there are some drawbacks to consider.
- MAT requires close medical supervision at a certified facility
- The powerful medications used may have undesirable side effects
- The medications provide the potential for misuse or abuse
- There is the risk of trading one addiction for another
It is the last point that concerns advocates of an abstinence-based approach the most. Some argue that MAT shifts the dependency from one drug to another. Though this is technically true, by following treatment guidelines, the safer drugs can be slowly tapered under medical supervision to alleviate dangerous withdrawal symptoms and to minimize cravings, thereby enabling more successful recovery outcomes.
The Use of MAT for Alcohol Use Disorder
Medication-assisted treatment may also be beneficial for treating alcoholism, especially when psychosocial methods alone have failed. Several drugs are available for this purpose with a range of supportive effects. Disulfiram serves as a deterrent to alcohol use when taken daily by mouth as it causes a physical reaction that includes nausea and vomiting, flushing, and heart palpitations. Naltrexone, taken daily by mouth or monthly as an extended-release injection, blocks the rewarding effects of alcohol consumption as well as the cravings for alcohol. And finally, acamprosate taken orally as extended-release tablets helps to reduce the desire to drink by addressing the changes to the brain brought on by long-term alcohol use. All of these medications must be used with medical supervision and monitoring for side effects. Their use may help to support abstinence and prevent relapse.
Deciding on the Right Treatment Strategy for You
If after examining the medication-assisted treatment pros and cons, you determine that this may be the treatment choice that makes the most sense for you or a loved one, it is time to get the input of a specially-trained addiction medicine professional. With questions in hand, contact the admissions staff at the treatment center of your choice. This is a good opportunity to learn about their options for MAT. Be ready to ask questions and share your concerns.
MAT has emerged as a safer, more effective way to address intractable substance use disorders with the significant backing of medical and public health authorities. The knowledgeable individuals who specialize in substance abuse rehab can help you decide if this type of treatment program is right for you. They can assist you with getting insurance authorizations and help make this evidence-based intervention a reality for your recovery journey.
It is important to consider treatment providers with medication-assisted treatment options when looking to ween off any substance, but especially with opioid drugs or alcohol.
At New Choices Treatment Centers, we take a “whole-patient” approach to the treatment of substance use, by offering MAT in combination with other evidence-based treatment options such as counseling, behavioral therapy, and active recovery, among others. We also offer family therapy, as we know having that support in the background can make all the difference. In terms of standard of care, we sacrifice nothing to ensure people get the help they need.