Navigation: Is Medication-Assisted Treatment Evidence-Based?, How Does Medication-Assisted Treatment Work?, Is Medication-Assisted Treatment Effective?, What Drugs Are Used Most Commonly Used in MAT?, Opioid Treatment Programs: Other Treatments for Opioid Use Disorder
For people with opioid use disorders (OUD), medication-assisted treatment (MAT) can work wonders. This treatment involves the use of medications in combination with behavioral treatment and counseling. This combination can be beneficial for patients who are struggling with adverse health effects and psychological cravings caused by opioid use. [1]
OUD is a chronic disease with long-lasting effects. The goal of MAT is to help patients with SUDs reduce their cravings and withdrawal symptoms, ultimately promoting recovery and reducing the risk of relapse.
There are three drugs that are approved by the US Food and Drug Administration (FDA) for the treatment of opioid use disorder. These are buprenorphine, naltrexone, and methadone. These medications for opioid use disorder (MOUD) have all been demonstrated to be safe and effective when it comes to treating those who have the condition. [1]
One of the most common questions regarding opioid use disorder medication-assisted treatment is whether or not it is considered a type of evidence-based treatment. This is what we’re going to discuss here today.
Is Medication-Assisted Treatment Evidence-Based?
The short answer is yes, it is considered an evidence-based treatment that is mainly used for opioid use disorder and alcohol use disorder (AUD). Opioid use disorder MOUD such as methadone, naltrexone, and buprenorphine are used to reduce cravings and withdrawal symptoms, which commonly occur during substance abuse treatment.
These FDA-approved medications make it easier for addicted individuals to focus on their recovery. Evidence-based treatment options are necessary because addiction is a chronic and relapsing disorder that needs to be addressed properly.
Since the 1970s, the treatment of substance use disorders has grown rapidly. Now it comprises a significant component of the US health care industry. Evidence-based practices are highly encouraged as they can significantly improve outcomes of those with OUD and other substance use disorders. [2]
Medication-assisted treatment already has a strong body of research that supports its clinical use. Even doctors advocate for the use of drugs to help patients overcome their addiction. The goal of MAT is to help wean patients off of their physical dependence on harmful substances. [2]
Numerous studies and clinical trials have shown that MAT is effective in improving retention in treatment programs as well as decreasing the risk of overdose and other opioid-related complications.
In fact, MAT has been endorsed by organizations such as the Substance Abuse and Mental Health Services Administration (SAMHSA), the National Institute on Drug Abuse (NIDA), and the World Health Organization (WHO) as a proven and effective approach to OUD treatment.
Keep in mind that the effectiveness of MAT may vary depending on the individual and their specific circumstances. This means treatment decisions should be made on a case-by-case basis in consultation with a healthcare provider.
How Does Medication-Assisted Treatment Work?
MAT combines medications and behavioral treatment to treat substance use disorders like opioid addiction and alcoholism.
As we mentioned earlier, there are three FDA-approved medications for MAT. Methadone is an opioid agonist that does not block other narcotics while preventing withdrawal. It is only dispensed in specialty regulated opioid treatment clinics. [3]
Buprenorphine is a partial opioid agonist prescribed in physician offices and is the first medication to treat opioid use disorder. Meanwhile, naltrexone is a non-addictive opioid antagonist that can block the effects of other narcotics. Naltrexone works by blocking the effects of opioids and reducing alcohol cravings. It is administered in a healthcare provider’s office as a daily pill or a monthly injection.
Medication-assisted treatment is necessary because quitting addictive substances cold turkey can cause a wide range of physical and mental health problems. In some cases, going cold turkey on these substances can prove fatal. This is why doctors discourage it.
MAT helps patients reach their recovery goals more easily. It also keeps them safe from the more devastating withdrawal symptoms of opioid use disorder and AUD.
By mitigating these life-threatening and uncomfortable symptoms, recovering individuals stand a better chance of getting sober again.
MAT is most effective when combined with counseling and behavioral therapies. These therapies can help patients address the underlying issues and triggers that contribute to their substance use. At the same time, they get to spend some time learning and developing healthy coping strategies.
Medication-assisted programs typically involve regular monitoring by health care professionals to ensure that the medication is being used as prescribed. Regular monitoring also allows them to make necessary adjustments based on how the patient is adapting to it.
Remember that MAT is not a one-size-fits-all approach. Treatment plans should be tailored to each individual’s unique needs and long-term recovery goals. The best rehab centers create a personalized treatment program based on the patient’s needs. After all, everyone is affected by addiction differently.
Is Medication-Assisted Treatment Effective?
We’ve mentioned that medication-assisted treatment is perfect for reducing uncomfortable withdrawal symptoms, allowing patients to concentrate on their recovery without the painful distractions of withdrawal. But MAT comes with even more benefits.
Over the past half century, a wealth of evidence about OUD treatment medications has been collected from randomized controlled trials, clinical studies, meta-analyses, and systematic reviews. The results are clear: agonist medication is the safest option for treating opioid use disorder. [4]
Agonist treatment, according to a review of OUD treatment medications, is the best in terms of reducing opioid use in patients and retaining patients in care.
Longer treatment durations often lead to better outcomes, as patients have more time to address the underlying issues contributing to their addiction.
The risk of death from OUD is also lower in people who are undergoing long-term methadone or buprenorphine treatment, compared to when they are untreated. The mortality reduction is approximately 50 percent among those who received long-term treatment with agonist medication for their OUD. Increased access to these medications is also associated with reduced opioid overdose deaths. [4]
Medications like naloxone, which can reverse opioid overdoses, are often included as part of MAT programs.
Methadone and buprenorphine treatment are also associated with lower rates of other opioid use.
MAT medications, such as methadone, buprenorphine, or naltrexone for opioid addiction, and Acamprosate or disulfiram for alcohol addiction, help reduce cravings for the substance, making it easier for recovering individuals to abstain from drug or alcohol use.
This type of treatment can even help address co-occurring mental health disorders, as addiction and mental health often go hand in hand. Managing substance use can make it easier to treat other mental health conditions effectively.
MAT has been shown to be effective in helping individuals with opioid and alcohol use disorders reduce their substance use and improve their overall well-being.
In the long run, medication-assisted treatment is more cost-effective. This is because it reduces the burden on healthcare systems by decreasing emergency room visits, hospitalizations, and other costly consequences of substance abuse.
This is why the effectiveness of MAT is supported by many doctors. It’s natural that healthcare providers would rather have patients be on a drug that allows them to live healthy, fulfilling lives than drugs that can harm them. [4]
Overall, MAT can improve a person’s quality of life. By stabilizing their substance use disorder, they can focus on rebuilding relationships, pursuing education or employment, and engaging in healthier activities.
With all that said, it’s important to note that MAT is just one part of a comprehensive approach to addiction treatment. It should be integrated with counseling, support groups, and other forms of behavioral therapy to address the holistic needs of patients in recovery.
What Drugs Are Used Most Commonly Used in MAT?
There are several FDA-approved buprenorphine products for the treatment of opioid dependence, such as Brixadi, Bunavail, Cassipa, Probuphine, Sublocade, Suboxone, Subutex, and Zubsolv. Bunavail, Suboxone, and Cassipa are made of buprenorphine and naloxone. Sublocade is an extended-release injection of buprenorphine. Some of these come in the form of a tablet, buccal film, sublingual film, or an implant for subdermal administration. [1]
Meanwhile, the FDA-approved methadone products for opioid dependence are Dolophine and Methadose. Dolophine is a methadone hydrochloride tablet while Methadose is a methadone hydrochloride oral concentrate.
Finally, Vivitrol is another Naltrexone product approved by the FDA for opioid dependence treatment. It is administered intramuscularly as an extended-release version of naltrexone. [1]
As for alcohol use disorder, there are several medications that have been found helpful such as benzodiazepines.
Benzodiazepines are considered the primary choice for the treatment of AUD. There are many types of benzodiazepines, but they are typically administered at high doses in the early stages of treatment, and then the patient is gradually weaned off it as their condition improves.
Medications like diazepam and chlordiazepoxide are administered to control the patient’s withdrawal symptoms.
Another commonly-used medication is lorazepam, which is an anti-anxiety drug. It has anticonvulsant properties that help to prevent seizures in patients undergoing withdrawal from alcohol use disorder. When it comes to the treatment of alcohol withdrawal, it is said to have an “excellent record of efficacy”. [1]
The specific medications used for opioid use disorder and alcohol use disorder may vary depending on the patient’s specific condition and withdrawal symptoms.
Opioid Treatment Programs: Other Treatments for Opioid Use Disorder
According to the American Society of Addiction Medicine (ASAM)’s treatment recommendations for OUD detailed in its 2020 National Practice Guideline, patients should be offered or referred to psychosocial treatment in collaboration with qualified behavioral treatment providers, depending on their needs. [5]
In addition to medication-assisted treatment there are several other treatments that can be used to treat opioid addiction and other types of substance use disorders.
So while medication-assisted treatment is a widely recognized as an effective approach for treating opioid addiction, it is far from being the only option. It is also widely known that MAT should be combined with behavioral therapies to give patients a comprehensive and holistic treatment.
Various treatments and strategies can be used in conjunction with or as alternatives to MAT for OUD, depending on patients needs and preferences.
Various behavioral therapies can be effective in treating OUD, either alone or in combination with MAT. These therapies include Cognitive-Behavioral Therapy (CBT), contingency management, and motivational interviewing (MI).
Cognitive-behavioral therapy helps patients identify and change unhealthy thought patterns and behaviors that are keeping them addicted. These therapies are designed to get to the root causes of addictive behavior. When a patient understands the causes of their condition, as well as the triggers and stressors that are pushing them towards substance abuse, it will be easier for them to formulate a plan of action.
Recognizing triggers can help you utilize healthy coping mechanisms that are meant to protect your sobriety.
Contingency management is a type of therapy that provides incentives for maintaining abstinence and achieving treatment goals. This is perfect for keeping patients motivated throughout their recovery journey.
Meanwhile, motivational interviewing is patient-centered approach that helps people explore and resolve ambivalence about their substance use and treatment. It is designed to strengthen personal motivation by exploring the patient’s reasons for pursuing change. [6]
Additionally, individual and group counseling can provide emotional support, coping strategies, and relapse prevention skills. Counseling can be a standalone treatment or used alongside MAT. Some rehab centers also offer family therapy.
Involving family members in the treatment process can help improve family dynamics and support the patient’s recovery. It also establishes a healthier support system, which is necessary for the person in recovery. Sometimes family members themselves could serve as triggers for substance abuse, and that’s something that needs to be resolved. In some cases, family members enable their loved one’s behavior, making it harder for them to get sober or maintain their sobriety.
Family members need to learn how to support their addicted loved one properly. This is where family therapy comes in.
Aside from friends and family members, recovering individuals can also build their support network with strangers who have gone through similar experiences and struggles. Attending support groups and 12-step programs like Narcotics Anonymous (NA) or Alcoholics Anonymous (AA) can help make patients feel less alone. They can also gain insights and inspiration from people who have gone through the same challenges.
Participation in recovery support groups like SMART Recovery or Refuge Recovery can provide peer support and a sense of community for people in recovery.
Some facilities offer supportive services like case management, housing assistance, vocational training, and access to social services to address the broader needs of patients with OUD or AUD.
Aside from evidence-based treatments, there are also alternative treatments that work best as complementary therapies such as acupuncture, yoga, mindfulness meditation, dance therapy, music therapy, and art therapy. These programs are designed to provide a holistic treatment experience for patients. They can help with stress management and relapse prevention.
Rehab can be done in an inpatient or outpatient setting. Those with mild to moderate addiction may benefit more from outpatient treatment, while those with severe addiction may benefit from the structured approach used in residential rehab. One is not necessarily better than the other. It’s all a matter of finding the right fit for the patient.
Patients may also be encouraged to maintain a healthy lifestyle. A healthy lifestyle may involve getting regular exercise, getting plenty of sleep, and maintaining a balanced diet. All of these healthy habits can support recovery by improving the patient’s physical and mental well-being.
The most effective approach for treating substance use disorders often involves a combination of several of these strategies tailored to the individual’s unique needs and preferences. If you or someone you love is addicted to drugs or alcohol, look for a rehab near you today. Learn more about the available treatment options and get started on the road to recovery.
Sources:
[2]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4282519/
[3]: https://www.hhs.gov/opioids/treatment/medications-to-treat-opioid-addiction/index.html
[4]: https://www.ncbi.nlm.nih.gov/books/NBK541393/
[5]: https://www.cdc.gov/opioids/healthcare-professionals/prescribing/opioid-use-disorder.html#
[6]: https://motivationalinterviewing.org/understanding-motivational-interviewing
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