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History of Medication Assisted Treatment

Medication-assisted treatment, also known as MAT, is an evidence-based approach to treating substance use disorders.

Navigation: What is Medication-Assisted Treatment?, A Brief History of Medication-Assisted Treatment, Modern Medication-Assisted Treatment, Why You Should Consider MAT for Opioid Use Disorder, Rehab Is Your Best Chance


Even today, medication-assisted treatment or MAT is still considered the gold standard for opioid use disorder (OUD) treatment. [1]

This treatment can help stop the widespread use of opioids and other addictive substances. In fact, it has been shown to benefit those who inject drugs into their bloodstream and those who engage in illicit opioid use by reducing the frequency of their substance abuse. [1]

Unfortunately, opioid addiction is still a very common problem. Different substance abuse treatment programs may be able to reduce opioid overdose deaths, but not everyone has access to these treatments and other human services for addiction recovery.

It is therefore worth exploring the history of medication-assisted treatment so that we can use this information as a guide to see how this treatment can evolve in the future and how it can continue to save lives.


What is Medication-Assisted Treatment?

Medication-assisted treatment, also known as MAT, is an evidence-based approach to treating substance use disorders. However, it is primarily used to treat opioid addiction and alcohol use disorder (AUD).

MAT combines the use of medication with counseling, behavioral therapies, and support services to provide comprehensive care for those who are struggling with addiction. Done properly, MAT can help people sustain recovery. [2]

The primary goals of MAT are to reduce the harmful effects of substance abuse, prevent relapse, and support long-term recovery.

While it is very effective when it comes to achieving those goals, more can be done to facilitate these treatment services like making sure more patients admitted to rehab centers have access to medication-assisted treatment, breaking the stigma surrounding addiction, and finding new ways to advance OUD and other similar treatments. [2]

As the name suggests, MAT involves the use of prescription medications that are approved by the U.S. Food and Drug Administration (FDA) for the treatment of substance use disorders.

In the case of opioid use disorder, medications like methadone, buprenorphine, and naltrexone are commonly used. Meanwhile for alcohol use disorder, medications like disulfiram, Acamprosate, and naltrexone are often prescribed.

The three drugs approved by the FDA for treatment of opioid dependence (methadone, naltrexone, and buprenorphine) have all proven to be safe and effective especially when combined with other traditional treatment services like counseling and behavioral therapies. [2]

Using it in combination with therapies is essential because ultimately, medications are only one part of MAT. Addiction is a complex condition after all, and health care providers must also address the psychological and social aspects of addiction in order to facilitate long-term recovery.

Therapy helps patients understand and modify the behaviors that contribute to their substance use. It helps them understand the root causes of their addiction, preparing them for the next phase of recovery, which is learning healthy coping mechanisms.

Recovering individuals need to keep working on their sobriety even after they leave rehab. This is why healthy coping mechanisms often come in handy. During their stay in rehab, they can learn various techniques that will help them maintain their sobriety.

But the good news is that they won’t be doing it alone. The treatment process often involves support services that seek to assist those in recovery.

Support services, such as access to housing, employment assistance, and community resources, can be crucial for patients in recovery. These services help them rebuild their lives and develop a support network to maintain abstinence.

Keep in mind that just like other treatment methods, MAT is an individualized approach. This means the choice of medication and treatment plan may vary based on the specific needs and preferences of the patient. It’s important to work with healthcare professionals who are trained in addiction medicine to determine the most appropriate course of treatment based on the person’s specific needs and condition.


A Brief History of Medication-Assisted Treatment

MAT has been shown to be effective in reducing overdose deaths and preventing relapse for people struggling with opioid addiction, alcoholism, and other types of substance use disorders. But how did this treatment come to be?

Since it is deeply connected to opioid use disorder, we should mention that this disorder has its roots as far back as the 1800s, back when these substances were being used in the Civil War for the treatment of injured soldiers. [3]

While it was mostly used for medical treatment, its addictive nature quickly affected the general public. The spread was so quick that by the 1950s, steps already had to be taken towards controlling this new type of addiction.

In 1956, there was a feasibility research conducted by the American Medical Association looking into using opioid medications in an opioid treatment program. [3]

In the 1960s, methadone treatment emerged. Methadone was actually the first medication used to treat opioid addiction. Dr. Vincent Dole and Dr. Marie Nyswander began using methadone to treat heroin addiction, marking the birth of medication-assisted treatment.

During this time, it was found that methadone maintenance treatment could help reduce illicit opioid use and improve treatment outcomes. Patients addicted to opioids enjoyed improved school attendance, employment, and overall quality of life. [3]

In the 1970s, methadone maintenance programs expanded in the US as well as other countries. It was found that methadone could help reduce opioid cravings and withdrawal symptoms, which is why it became more widely recognized.

In the early 1980s, research for better medications against opioid addiction continued. Eventually, the National Institute on Drug Abuse (NIDA) finished testing naltrexone for opioid addiction treatment. They found that it could help highly motivated patients who have already undergone medical detox. However, they found that it required consistent use, meaning the medication was not a perfect solution. [3]

Modern Medication-Assisted Treatment

The current opioid epidemic actually began in the 1990s due to the fact that prescription painkillers became widely available. Substances like oxycontin and fentanyl continue to contribute to fatal overdoses, which still occur on a daily basis. Eventually, heroin use rose as well, which is why we have our current opioid epidemic. [3]

In 1991, there were around 76 million opioid prescriptions written by health care professionals. Compare this with the 207 million prescriptions that were written in 2013.

Unfortunately a lot of people who developed OUD began taking opioids because of a prescription. Opioids are commonly used for pain relief, but its over prescription has led to a huge problem in the health sector.

In 1997, a panel from the National institute of Health or NIH called for reform in drug regulation, particularly the ones that are used to treat addiction. This contributed to the development of medications like suboxone, vivitrol, and sublocade, which are now being used in modern MAT. [3]

The 1990s also saw the introduction of buprenorphine, which was approved by the FDA in 2002 for the treatment of opioid addiction. Buprenorphine has several advantages over methadone, including a lower risk of overdose and greater accessibility due to its office-based prescribing model.

The early 2000s marked a period of increased acceptance and availability of MAT, with the passing of the Drug Addiction Treatment Act (DATA) in 2000, which allowed qualified physicians to prescribe buprenorphine.

In the 2010s, additional medications for MAT were introduced such as extended-release naltrexone and the combination medication buprenorphine/naloxone. These options provided more choices for patients seeking treatment.

Overall, MAT has been a crucial component of efforts to combat the opioid epidemic. But now there are still plenty of ongoing efforts to combat this major public health crisis. Policies and initiatives have focused on expanding access to MAT and reducing barriers to treatment.

MAT has even been adapted for other substance use disorders, including alcohol use disorder. Medications like naltrexone and Acamprosate have been used to assist in the treatment of patients struggling with alcohol addiction.

Opioid dependence not only affects the addicted individual but also their family members and even the communities they live in. This is why it is important to consider medication-assisted treatment and other addiction treatment options.

Why You Should Consider MAT for Opioid Use Disorder

It goes without saying that medication assisted treatment is a valuable approach for people struggling with substance use disorders, particularly opioid addiction.

It is widely recognized as an effective treatment for a reason. By combining medications with counseling and behavioral therapy, health care providers can address the physical and psychological aspects of addiction, giving patients the best chances of making a full recovery.

Medications like methadone, buprenorphine, and naltrexone help reduce cravings and withdrawal symptoms, allowing individuals to focus on their recovery.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), medications like buprenorphine, methadone, and naltrexone are commonly used for OUD treatment because they normalize brain chemistry. They can effectively block the euphoric effects of opioids as well as alcohol. [4]

Because of these effects, the medications can normalize body functions while keeping cravings and symptoms under control. These three FDA-approved medications can help treat OUD for heroin, codeine, morphine, and even semi-synthetic opioids like hydrocodone and oxycodone. [4]

MAT can also significantly reduce the risk of overdose, which is a major concern for people with opioid addiction. By blocking the euphoric effects of these substances, it becomes much harder for people to keep abusing their medications, meaning the risk of overdose is much lower.

The best part is that these medications are safe to use even for a lifetime. That said, you still want to consult with your doctor before discontinuing use of these medications.

Studies have shown that those who undergo MAT are less likely to relapse than those who attempt to quit opioids without medication. This means that MAT works as an effective harm reduction approach. It acknowledges that not everyone is ready to abstain from opioids immediately, but it helps them make progress toward recovery.

Another important thing to consider is the fact that MAT is administered under medical supervision. This ensures that patients receive the correct dosage and care they need. This helps prevent misuse of medication and ensures their safety.

At the end of the day, medication assisted treatment can help people regain control over their lives.

By stabilizing their opioid use and reducing cravings, people can focus on rebuilding relationships, finding employment, and pursuing their personal goals.

Medication assisted treatment can be tailored to the individual’s needs, and the choice of medication can be adjusted over time as necessary. This allows for a personalized and flexible approach to treatment.

Remember that just like other rehab treatments, MAT is not a one-size-fits-all solution. Its appropriateness depends on the patient’s specific circumstances. For the right patients, MAT can serve as a valuable lifeline that helps them regain control over their lives. It allows them to work towards lasting sobriety.

If you or someone you love is dealing with opioid addiction, or any other type of substance use disorder, consult with a healthcare professional to discuss the potential benefits of MAT as part of a comprehensive treatment plan. Look for a rehab near you today to learn more.

Rehab is Your Best Chance

Treatment is an addicted individualʼs best option if they want to recover. Beating an addiction not only requires eliminating the physical dependence, but also addressing the behavioral factors that prevent them from wanting to get better. Simply quitting may not change the psychological aspect of addiction. Some people quit for a while, and then take drugs or alcohol again, only to overdose because they did not detox properly. Recovery involves changing the way the patient feels, thinks, and behaves.


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Fel Clinical Director of Content
Felisa Laboro has been working with addiction and substance abuse businesses since early 2014. She has authored and published over 1,000 articles in the space. As a result of her work, over 1,500 people have been able to find treatment. She is passionate about helping people break free from alcohol or drug addiction and living a healthy life.

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