July 2, 2019

Medication Assisted Treatment: Separating Myths from Facts

Medication Assisted TreatmentTreatment (MAT) is an evidence-based practice used to treat substance abuse disorders, specifically nicotine use disorder, alcohol use disorder, and opioid use disorder. Medication-assisted treatment (MAT) is the use of medications in addition to counseling and behavioral therapies to treat substance use disorders and prevent opioid overdose. FDA approved medications are given to individuals to alleviate painful withdrawal symptoms, decrease cravings, and help prevent relapse. MAT is known to be successful when used in conjunction with behavioral therapies; however, there is a lot of misleading and false information in regards to MAT. One of the ways to combat the stigma associated with substance abuse treatment is to differentiate myths from facts; especially in regards to treatment approaches.

Myth: MAT trades one addiction for another

Fact: MAT for opioid use disorder provides individuals a taper of long-acting opioid medications as a way to wean them off of stronger opioids such as heroin.

This is probably the most commonly talked about myth when it comes to medication-assisted treatment. Methadone is a common long-acting opioid that is used in MAT to help wean individuals off of heroin and other addictive opioids. The methadone dose is carefully titrated up, so the individual has minimal withdrawal effects, and over a few days to weeks, the individual will be weaned off of methadone safely. However, often MAT is used for long-term as a low dose alternative to heroin. Appropriately prescribed agonist addiction medications such as methadone and partial agonist addiction medications such as buprenorphine reduce drug cravings and prevent relapse without causing a “high.” Methadone is much different from short-acting opioids such as heroin and prescription painkillers, and although it does have an addiction potential; it is much weaker and when prescribed correctly in combination with behavioral therapy, will not leave the individual with a new addiction.

Myth: MAT is a short-term treatment option

Fact: MAT can often be used as a long-term, and even lifelong treatment option.

Research has shown that individuals on MAT for at least 1-2 years have the highest rates of long-term success. There is currently no evidence to support benefits from cessation. Individuals with long-term abstinence can follow a slow taper schedule under a physician’s direction, when free of stressors, to attempt dose reduction or total suspension.

Myth: MAT is not effective

Fact: MAT has been shown to decrease opioid use, opioid-related overdose deaths, criminal activity, and infectious disease transmission.

Studies have shown that after buprenorphine became available, rates of heroin overdose drastically decreased, and extended-release naltrexone is associated with a rate of opioid relapse that was lower than that with usual treatment. MAT also increases social functioning and retention in treatment and improves outcomes for opioid-dependent pregnant women and their babies by reducing symptoms of neonatal abstinence syndrome and length of hospital stay.

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