Not everyone can stop their substance use cold turkey. Actually, very few are capable of this. The facts speak for themselves: the success rate for most abstinence programs is at a paltry 10 percent. That is why medication assisted treatment, also known as MAT, is available and a very successful way to treat substance abuse disorder, allowing individuals to recover long-term. MAT has been approved by the FDA for use with substance use disorder, alcohol use disorder and smoking.
Medication assisted treatment has been around since just after the Civil War; however, methadone, one of today’s go-to medications, was developed in 1962 by Dr. Vincent P. Dole for the treatment of opiate addictions at that time. Our recent opioid crisis has fueled resurgence in the need for MAT since abstinence programs do not work very well. In the 1990s, methadone treatment was only for illegal drug users but was effective enough, showing that two-thirds of those getting the treatment were able to stop using or lower their need to use, according to a 1994 California study by the California Department of Alcohol and Drug Programs, as cited by SAMHSA publication Medication-Assisted Treatment For Opioid Addiction in Opioid Treatment Programs. This was also the time when the opioid crisis started. It wasn’t until the year 2000 that the FDA and the Substance Abuse and Mental Health Services Administration (SAMHSA) had given the go ahead to use MAT for prescription opioid patients with an opioid use disorder. Since then, new medications have been added to the arsenal in the fight against opioid addiction.
Opioids were intended to be a short-term pain reliever. Unfortunately, they started to be prescribed for long-term and severe pain. As the patient continues use of the prescribed opioid, the effects lessen and a larger dosage is required to achieve the same effect. Also, after prolonged use, the body develops a dependence on the drug and the person becomes addicted. This can lead to withdrawal symptoms and ongoing abuse as well as illegal opioid use, such as heroin.
Alcoholism is an inability to control one’s drinking due to both physical and emotional dependence. There is binge drinking, maintenance drinking and heavy drinking. In each case, the individual may feel guilty about their drinking and may wish to cut down. There may even be health or legal issues surrounding the drinking. No matter the dire consequences, with alcohol addiction, the individual cannot stop consumption.
Treatments for these addictions have been cold turkey detox followed by 12-step programs and abstinence. These programs, contrary to popular belief, have not been very successful. This is why medication assisted treatment has become a more realistic approach for substance and alcohol use disorders. At Remedy Recovery, MAT is included with counseling and behavioral therapies through a “whole patient” approach to treatment. Individuals are treated as patients suffering with a chronic disorder, rather than social outcasts with character flaws and moral failings.
What Can MAT Do?
Medication assisted treatment makes detox easier by alleviating some of the withdrawal symptoms and pain associated with it. Once the detox is done, MAT can help sustain recovery for patients who are struggling with their addiction by reducing the opioid or alcohol craving. Medication also helps restore normal brain function, block the euphoric effects of the alcohol and opioids, and normalize body functions without the negative effects of the substance used. The risk of a relapse or an overdose is lowered with MAT. Coupled with counselling and behavioral therapy to support the recovery process, each patient has an improved ability to recover from the addiction. More importantly, using MAT helps the individual gain or return to employment and feel normal again.
MAT provides a more comprehensive, individually tailored program of medication with cognitive, physiological and behavioral therapies. There are a few medications out there for use, including methadone, buprenorphine and naltrexone for opioid use disorder. For alcoholism, disulfiram, acamprosate, and naltrexone are the medications most commonly prescribed. In California, because the use of cannabis has been legalized for all adults, marijuana can be an option. It is considered a harm reduction measure if an individual cannot or does not wish to use the other medications available.
MAT for Post-Acute Withdrawal Symptoms
During the initial withdrawal, a patient will suffer from anxiety, sleeplessness, muscle aches, abdominal cramping, nausea, vomiting and hot and cold sweats. This can last up to a month after cessation of use. Post-Acute Withdrawal Symptoms (PAWS) starts when the other ends, and while the effects are not as acute as the initial withdrawal symptoms, they can still jeopardize recovery and increase the risk of a relapse, especially if the person is not fully informed as to what to expect. These symptoms include anxiety, sleep problems, memory and attention issues, cravings, and depression and can last up to two years after the initial recovery was started. Medication assisted treatment is extremely important during this phase in order to monitor the patient’s current status, progress and to keep a relapse from occurring. As long as the individual is willing to continue with MAT, they will be able to make it through PAWS.
MAT Broadens the Scope of Treatment and Recovery
Each individual is different and each has different needs in their recovery. Some may respond very well to total cessation of use and abstinence. Other individuals may need a course of medication before cessation and recovery is complete. Others yet might need medication for a longer period of time. Because each individual is different, the MAT approach is to tailor the recovery program to the needs of the individual patient, managed and monitored over time to adjust when necessary and achieve the desired results.