Medication Assisted Treatment (MAT) combines cognitive-behavioral therapies and medications to aid in the treatment of patients suffering from substance abuse. Studies have shown that people who go through opioid detoxification and treatment without the aid of maintenance drugs suffer higher incidence of relapse. Treatment plans that include medication-assisted therapies are designed to stabilize the drug- or alcohol-addicted person for further treatment and help them return to a more functional state.
The advent of medication-assisted treatment really emphasizes the underlying complexity of alcohol, opioid/opiate, and stimulant addictions in particular. These are drug types that create strong and lasting cravings with long-term effects on the brain that can lead to challenging and even life-threatening withdrawal side effects. The medications help to reduce cravings and withdrawal symptoms to make treatment more manageable.
When Is Medication Assisted Treatment Used?
While there are medications designed to offset cravings in drugs like marijuana and nicotine, medication-assisted treatment is most often associated with three primary drug types: Alcohol, opioid/opiates, and stimulants.
In most cases, people using medications to achieve recovery are tolerant to the drug and take it to avoid dangerous withdrawal side effects. These types of medications typically work as opioid antagonists, binding with the opioid receptors to prevent withdrawal symptoms, and eliminate or reduce drug cravings. When someone attempts to use while on these medications, the opioid receptors are unable to bind with the compound, preventing any euphoria typically associated with use of the drug.
Other medications work by altering the way the body metabolizes a drug. These medications act as drug deterrents, making the person feel ill if they attempt to use while on the medication
Medication Assisted Treatment used most often to treat:
Medications Used In The Treatment Of Addiction
A drug common to all three types of addiction, naltrexone, is an effective opioid antagonist. This drug binds with opioid receptors, resulting in an overall reduction in withdrawals and drug cravings. This medication is also used to treat stimulant and alcohol addiction, as all three drug types impact the opioid system. Certain opioid peptides stimulate the release of dopamine, part of the reward system in the brain.
When these drugs are used with someone who has been drinking or using for a long time, they work against the side effects normally exhibited when this opioid-tied dopamine response fails to occur. The medication blocks the receptors, allowing the body to get what it needs to function, but without the side effects associated with alcohol, opioid, or stimulant abuse. In other words, the drug stabilizes the drug- or alcohol-addicted person to relatively normal function.
Even if someone tries to abuse drugs or alcohol while on a drug like naltrexone, the opioid receptors are blocked, and they will not feel the highs normally associated with the substance. This same process reduces drug cravings.
In the treatment of alcohol addiction, other drugs like acamprosate and disulfiram are also used. Acamprosate acts on the body’s GABA receptors, which are rendered practically useless with chronic alcohol abuse. Gamma-Aminobutyric Acid (GABA) has an inhibitory effect on the firing of nerve signals throughout the central nervous system (CNS). Alcohol acts so rampantly on GABA, that the number of GABA receptors are reduced significantly with chronic drinking, so that when someone stops, they are no longer able to regulate nerve firing along the CNS. This means someone going through alcohol withdrawal is at risk of complications associated with high blood pressure, seizures, and rapid heart rate.
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Acamprosate accommodates the body’s need for a similar process to reduce this nerve excitability while allowing the body time to rebuild GABA receptors along the CNS.
Disulfiram, known more commonly as antabuse, acts on a different process within the body to deter people from drinking. Disulfiram alters how the body metabolises alcohol so that when someone drinks alcohol while taking disulfiram, the process by which alcohol is normally oxidized is halted, leading to significantly enhanced and immediate hang-over symptoms. A person drinking alcohol while on antabuse will experience severe headache, vomiting, and even heart palpitations and is an effective alcohol deterrent.
As mentioned previously, drugs like naltrexone are used to block opioid receptors and is now being used in place of drugs like methadone in people recovering from heroin and other opioid addiction. Both drugs allow someone who has developed a tolerance to heroin to prevent ongoing withdrawals without the sedative effects of the drug. This means someone can become a functional and productive member of society while managing their addiction. However, drugs like methadone have many risks (including methadone dependence) associated with use.
Buprenorphine works similarly, though it is a partial opioid agonist. Someone taking buprenorphine in the treatment of opioid addiction may still experience some euphoria, but with less tendency toward dependence. It is also a drug that may be taken at home, rather than dispensed at a facility, as is the case with methadone. As with other drugs used to treat opioid addiction, buprenorphine reduces drug cravings.
A combination of naltrexone and buprenorphine is being used to treat cocaine addiction for some. These drugs show promise in treating severe stimulant addiction by reducing overall drug cravings and managing withdrawal symptoms.
Medication Assisted Treatment Works
While it may seem counter-intuitive to some, studies have shown repeatedly that medication-assisted treatment works and is an effective tool in managing withdrawal symptoms, reducing cravings, and improving treatment outcomes for people with alcohol, opioid, and stimulant addictions.
These drugs can also benefit pregnant women who are in treatment for addiction, leading to more positive birth outcomes. And generally speaking, when someone gets into treatment and remains in recovery, society benefits with an overall reduction in disease prevalence and violent crime.
Positive Medication Assisted Treatment for Recovery Results:
Reduction in drug-related overdose deaths
Improved treatment outcomes
Positive birth outcome for pregnant women in recovery
Reduction in disease and violent crime
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