“Medication-assisted treatment works. The evidence is voluminous and ever growing. Failing to offer MAT is like trying to treat an infection without antibiotics.”
– Alex Azar II, Secretary of the U.S. Department of Health and Human Services, 2018-2021
In the ongoing nationwide effort to mitigate harm caused by the opioid overdose crisis, medication-assisted treatment (MAT) has emerged as an effective strategy to help individuals, families, and communities reduce rates of addiction, fatal overdose, and the negative personal, social, and financial consequences associated with opioid use disorder (OUD).
Medication-Assisted Treatment is the use of medication, in combination with therapy, counseling, and community support, to treat substance use disorders (SUD). MAT can be used to treat people with opioid use disorder, alcohol use disorder and nicotine use disorder. At Pinnacle Treatment Centers, we use MAT primarily for the treatment of opioid use disorder (OUD).
Research shows that MAT for opioid addiction decreases opioid use, opioid-related overdose, criminal behavior related to addiction, and the transmission of various infectious diseases. MAT also increases social functioning, the ability to manage basic life tasks, and time-in-treatment – all of which lead to better treatment outcomes and quality of life for people with opioid use disorder, when compared to treatment in non-MAT programs.
There are three medications approved by the Food and Drug Administration for the treatment of opioid use disorder (OUD). These medications are called medications for opioid use disorder (MOUD):
MOUDs work by either occupying or blocking opioid receptors in the human brain. Receptors are structures on brain cells that trigger the chemical reactions that relieve pain, induce euphoria, and cause various other physical reactions, including the respiratory depression associated with fatal overdose.
When MOUDs occupy opioid receptors in the human brain, they:
MAT with a MOUD approved by the FDA is considered the gold-standard treatment for opioid use disorder.
Methadone is a full opioid agonist, which means it completely occupies opioid receptors and prevents the action of other opioids – whether prescription or illicit – in the brain.
Buprenorphine is a partial opioid agonist, which means is partially occupies opioid receptors and creates a ‘ceiling effect’ on other opioids, meaning it prevents the extreme euphoria associated with opioid use, and significantly reduces respiratory depression associated with fatal opioid overdose.
Naloxone is a full opioid antagonist, which means it completely blocks the action of any chemical on opioid receptors, including prescription and illicit opioids.
There are two types of treatment centers that offer MAT programs:
In all cases, beginning or initiating participation in MAT requires a comprehensive biopsychosocial assessment performed by a licensed and qualified physician. A comprehensive assessment has five primary goals:
Patients with a primary care physician or a psychiatrist/therapist/mental health counselor should ask these providers first, because they should know their medical history and any special circumstances that may affect OUD treatment in an MAT program. Primary care physicians and psychiatrist/therapist/mental health counselors may not be trained in addiction medicine, but they can perform a professional screening for opioid misuse. If they identify opioid misuse in an initial screening, they can refer a patient for a comprehensive biopsychosocial evaluation administered by a specialist at treatment center for substance use disorder (SUD) that offers MAT.
MAT is considered a safe and effective approach to OUD treatment. However, there are specific populations that may require additional assessment to determine whether MAT is the best available treatment alternative:
This is a common misconception that increases stigma around MAT treatment. The simple answer is “No, it’s not.” Addiction experts and the federal government (the entity that creates the rules around MAT) both have the same position: a person engaging in MAT is in recovery.
In fact, we wrote a series of articles on this topic called “Methadone Mythbusters.” These articles are about methadone, but apply to buprenorphine, as well:
READ: “Do People Use Methadone to Get High?”
READ: “Do People on Methadone Lack Willpower?”