And Other Common Questions About This Newly Popular Addiction Treatment Approach
In August 2018, the American Medical Association (AMA) released a statement calling on policymakers to help those with opioid addiction in a way some might say is unconventional. The call for support comes after the CDC released startling statistics about the addiction crisis, including 72,000 fatal drug overdoses and 88,000 annual deaths attributed to excessive alcohol use in 2017.
The means of treatment that the AMA is recommending is an approach called medication assisted treatment – sometimes referred to as MAT – and in 2017-2018 over 15,000 physicians became certified to treat patients with opioid addiction in this manner.
“We know what works,” said Patrice A. Harris, M.D., chair of the AMA Opioid Task Force. “We can point to states where making access to medication assisted treatment (MAT) has been a priority, and the mortality rates are doing down. The Centers for Disease Control and Prevention (CDC) provisional numbers yet again underscore that this epidemic will not be reversed until we deal with access issues and stigma associated with opioid misuse.”
This article answers many of the most commonly asked questions about MAT, including:
- What is Medication Assisted Treatment?
- What Medications Are Prescribed as Part of Medication Assisted Treatment?
- Does MAT Just Substitute One Addiction For Another?
- How Long Will Someone Need to Use Medication Assisted Treatment?
- Who Can Treat An Individual With Addiction Using Medication Assisted Treatment?
- Why Aren’t More People Using MAT?
- What is SMART Recovery’s Stance on Medication Assisted Treatment?
- Additional Resources
What is Medication Assisted Treatment?
Medication-assisted treatment combines behavioral therapy and medications to treat substance use addiction. This means that treatment for individuals with opioid (and other) addictions could include FDA-approved medications, in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to the treatment of substance use addiction.
“For those with opioid use disorders, medications can save lives by helping to prevent relapses, ” says Joe Gerstein, MD, FACP president of the SMART Recovery Board of Directors.
According to the Substance Abuse and Mental Health Services Administration, this approach has been shown to:
- Improve patient survival
- Increase retention in treatment
- Decrease illicit opiate use and other criminal activity among people with substance use disorders
- Increase patients’ ability to gain and maintain employment
- Improve birth outcomes among women who have substance use disorders and are pregnant
What Medications Are Prescribed as Part of Medication Assisted Treatment?
Medications such as methadone, buprenorphine, naltrexone and naloxone could be prescribed in different situations and in a responsible manner to someone with an opioid addiction. These medications are used to manage dependence and addiction to short-acting opioids such as heroin, morphine, and codeine, as well as semi-synthetic opioids like oxycodone and hydrocodone.
Click here to read more about SMART’s approach to medication addiction.
Disulfiram, Acamprosate and naltrexone are often used to help treat someone with an alcohol addiction.
Click here to read more about SMART’s approach to alcohol addiction.
Does MAT Just Substitute One Addiction For Another?
This is a common misconception about MAT. MAT relieves withdrawal symptoms and psychological cravings that cause chemical imbalances in the body and provides safe and controlled level of medication to overcome the use of an abused opioid. And research has shown that when provided at the proper dose, medications used in MAT have no adverse effects on a person’s intelligence, mental capability, physical functioning, or employability.
How Long Will Someone Need to Use Medication Assisted Treatment?
People may safely take medications used in MAT for months, years, several years, or even a lifetime. An individual’s plan is created with their doctor, and plans to stop medication should always be discussed before making changes to their prescriptions or treatment.
Who Can Treat An Individual With Addiction Using Medication Assisted Treatment?
Methadone used in the treatment of opioid addiction can be prescribed and dispensed only through a SAMHSA-certified OTP. Buprenorphine-containing drugs, such as Suboxone can be prescribed by physicians who obtain a waiver from the DEA after taking specified training in the use of these drugs. Naltrexone, oral or injectable, can be prescribed by any licensed physician.
Click here to search SAMHSA’s opioid treatment program directory.
Why Aren’t More People Using MAT?
The slow adoption of these evidence-based treatment options for alcohol and opioid dependence is partly due to misconceptions about substituting one drug for another. Discrimination against MAT patients is also a factor, despite state and federal laws clearly prohibiting it. Other factors include lack of training for physicians and negative opinions toward MAT in communities and among health care professionals.
What is SMART Recovery’s Stance on Medication Assisted Treatment?
SMART Recovery supports the scientifically informed use of psychological treatment and legally prescribed psychiatric and addiction medication.
Although SMART Recovery publicly released its position on MAT in 2005, the organization has welcomed participants at meetings using legally prescribed medications since its beginnings. This includes drugs needed to treat mental health disorders, which are common among people trying to recover from addiction problems.
According to the SMART Recovery website, “As a whole, SMART Recovery is based on maximizing choices in life, and we don’t tell participants what they should choose. We offer SMART Tools, like the CBA, ABC, and HOV to help people think about how to live better.”
SMART Recovery also recently released a podcast on this topic, SMART Recovery Podcast: Can Medication Help Conquer Addiction, interviewing Donald Sheeley, MD who is uniquely positioned to speak on this topic, as a long-time volunteer at SMART, an Emergency Room physician, and as a practitioner in his own practice, “ACT SMART New York.”
Click here to read more about SMART Recovery’s stance on this and many other addiction-related topics.
Additional Resources on MAT
This article was written using information and statistics from the following resources. Please continue reading on the topic by visiting the following links:
- AMA Press Release – Released August 15, 2018
- National Institute on Drug Abuse – Overdose Death Rates
- CDC Fact Sheets – Alcohol Use and Your Health
- SAMHSA Medication and Counseling Treatment Information
- PubMed Abstract – Using Science to Battle Stigma in Addressing the Opioid Epidemic: Opioid Agonist Therapy Saves Lives
Other Helpful Websites:
- American Association for the Treatment of Opioid Dependence http://www.aatod.org
- American Society of Addiction Medicine http://www.asam.org
- Behavioral Health Treatment Services Locator http://findtreatment.samhsa.gov
- Buprenorphine Physician and Treatment Program Locator https://www.samhsa.gov/medication-assisted-treatment/practitioner-program-data/treatment-practitioner-locator
- Medication-Assisted Treatment for Substance Use Disorders https://www.samhsa.gov/medication-assisted-treatment
- National Alliance for Medication Assisted Recovery http://www.methadone.org
- National Alliance of Advocates for Buprenorphine Treatment http://www.naabt.org
- National Commission on Correctional Health Care http://www.ncchc.org
This is the very best presentation on many important dimensions of Medication Assisted Treatment
Where is the plan for treating chronic severe pain in the wake of this opioid crisis? Most people on prescription pain meds take them as prescribed but are being punished for others misuse. Do your numbers only include deaths from legal prescription overdose or does it include those overdosing on a heroin fentanyl combo? Many of those people have never had an rx for legal opioids. Do your numbers include the hundreds of suicides by patients unable to cope with the pain after forced tapering and sometimes rapid total withdrawal?
Your program is a great start but more discussion is required to figure out how to help the undertreated.
How to continue such a helpful program when the insurance companies here in SC don’t pay. $300.00 cash only per month just to get a script to stay sober is just to much for the average working citizen.
I really need to get back on a program. How soon can one sign up and start this?
You can find out more about SMART by visiting our website at http://www.smartrecovery.org We have loads of resources (look for the “toolbox”), a list of our local meetings, an online community, a bookstore with SMART publications, and more. We also have online meetings, and you are welcome to attend. Our meetings start with an opening statement followed by a short check in with everyone and then a discussion of the issues that come up in the check-in. During the discussion, cross-talk is encouraged and we learn from each other. Be sure to be online early, we do limit the size of the meetings and they fill up quickly. You will find people in all stages of recovery and working on recovery from many different substances or behaviors. You will also find that many have had 12-step experience and that many attend 12-step meetings AND use SMART as part of their recovery.
Hi Wendy. I am from S.C. I attend a MAT program that is government funded. Therefore I have no out of pocket cost. I would shop around for clinic that provides these “free” services. Your local hospital’s ER should have a list of places for you to contact.
great info on your site
It’s good that you point out that medication-assisted treatment for help reducing risk of relapse and death. My brother is addicted to heroin, and I’m considering finding medication-assisted treatment for him for that reason. I’m going to look for a good provider of medication-assisted drug addiction treatment in my area.
Great information there.
My dad has a substance use disorder. It’s been tough for him. He has been trying to quit, but after a week he relapses. I just want him to get help.
Thank you for reaching out. SMART has information, meetings, and resources to help you and your dad. You can go to http://www.smartrecovery.org/family to find tools dedicated to family helping a loved one. There are also dedicated Family & Friends meetings. There are also hundreds of meetings for your dad to attend. You can find them at http://www.smartrecovery.org/community.
Is there a brochure form of this article? SMART is one of the few recovery groups that embraces MAT and welcomes those like me who are presently on MAT. I think it would help countless others if a brochures could be left at offices of MAT providers. I think it would be a win win situation all around. It would be a win for those of us on MAT. It would be a win for the MAT providers because SMART would provide a very valuable adjunct to the service they provide. And finally it would provide a boon to SMART as it would facilitate getting more members.
Thank you for the suggestion. We will let our communications department know.