Do you feel lost in your fight against a substance use disorder?
If so, you are far from alone. There are 3 million people in the US and 16 million people worldwide suffering from opioid use disorder.
Don’t give up your fight. Instead, find a partner to fight alongside you who has the weapons to help you win.
Treatment is available that’s especially effective in battling opioid addiction. In fact, recent medical research backs opioid treatment programs like medication-assisted treatment.
Is this the solution you or a loved one is looking for? What do you need to know about this type of drug addiction treatment? Keep reading to see what medication-assisted treatment can do for your substance use disorder.
What MAT Treats: AUD and OUD
MAT or medication-assisted treatment is useful for two substance use disorders in particular. Those are alcohol use disorder (AUD) and opioid use disorder (OUD).
Alcohol use disorder is the new term in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) for disorders the DSM-IV called “alcohol abuse” and “alcohol dependence.” In merging these two disorders, AUD now has three levels or categories:
- Mild
- Moderate
- Severe
An important omission from the DSM-5 is legal problems, although it adds craving as part of the criterion for diagnosis with AUD.
A similar diagnostic criterion is in the DSM-5 for OUD, with a list of 11 symptoms. Two to three symptoms indicate mild OUD, four or five symptoms are moderate, while severe is six or more.
You’ll find the full list of DSM-5 criteria on this worksheet.
How MAT Works
MAT is not a medication-only treatment plan. MAT uses a combination of behavioral therapies, counseling, and medication for the effective treatment of OUD or AUD.
Cognitive behavioral therapy (CBT) is a method for psychologically treating many issues like depression, anxiety, and substance use disorders. While it’s an excellent method for improving psychological changes, it only acts on one’s mind.
Some core principles of CBT base these psychological problems, at least in part, on:
- Learned patterns of behavior
- Unhelpful and faulty ways of thinking
- Better ways of coping are available
In CBT, the patient will learn to recognize the distortions of their own self-image that are affecting them in problematic ways. They’ll gain a better understanding of their behavior and motivations, as well as that of others. They’ll also try to use the problem-solving skills they develop with their therapist to gain more confidence in their abilities.
Along with CBT, a drug and alcohol counselor will help give the patient the support they need to overcome a substance use disorder. The counselor will help them with their rehabilitation and help to act as an advisor. This can be part of a one-on-one or group session.
Counseling is a necessary part of MAT. Why? Because a support group (whether it’s a 12-step program or not) gives the patient a life-long long-term focus and surveillance for sobriety.
Finally, the third major part of MAT is the medication. Doctors administer medication to the patient in line with protocols that match their situation. Generally, those medications are given to stem withdrawals and then to deter them from returning to the substance.
Which Medications MAT Utilizes
Different medications are used to treat AUD and OUD. The FDA has approved these drugs for their use in MAT for the management of these disorders, or to help prevent a relapse into substance usage.
Let’s take a closer look at each condition.
AUD Medications in MAT
The medications used for AUD are taken orally or intravenously. Physicians and other health care professionals can help them understand how to take the medications correctly.
They include:
- Disulfiram
- Acamprosate calcium
- Oral naltrexone
- Extended-release injectable naltrexone (Naltrexone Implant)
Disulfiram helps manage patients to elect enforced sobriety. It’s a tablet taken by mouth and as often as directed by their physician. They can be crushed and mixed with water, tea, milk, soft drinks, coffee, or fruit juices.
Disulfiram causes unpleasant side effects when the patient consumes alcohol — even in small amounts. They occur around 10 minutes after alcohol consumption begins and lasts for at least an hour. It isn’t intended as a cure, but rather as a deterrent to drinking.
Acamprosate calcium is given to patients who have already stopped drinking alcohol. It aids in restoring the natural balance of neurotransmitters in the brain. It is an aid to sobriety but it doesn’t work well (or at all) if they take it when they’re still drinking alcohol.
Naltrexone, taken orally or as an injectable, is the main tool against the initial withdrawals from ending the consumption of alcohol. It’s used for both AUD and OUD because it doesn’t cause withdrawal symptoms after ending use.
For AUD, Naltrexone should be administered after the alcohol detox process. That is, they must administer Naltrexone once the patient is no longer physically dependent on a substance.
OUD Medications in MAT
The medications for treating OUD are slightly different but have some overlap. Opioid receptors are different from the mechanism that causes the euphoria we all experience from drinking alcohol.
However, alcohol does increase activity in the mesolimbic reward pathway — that is, the dopamine neurons. Alcohol also affects the cells that release endorphins, an “internal opioid.” This is why some medications may be used on both AUD and OUD.
Naltrexone is not an opioid and is non-habit-forming. It reduces or blocks the sedative and euphoric effects of heroin, codeine, morphine, and alcohol. It does this through binding with our opioid receptors.
Other medications used for treating OUD are Buprenorphine and liquid methadone. Methadone is a long-acting opioid agonist.
Buprenorphine is another type of opioid. Regardless, it’s used in the treatment of OUD. These medications can help to cope with OUD from natural or synthetic opioids in the course of MAT.
Medications for Opioid Overdose Prevention include Naloxone. Naloxone is on the essential medications list for any healthcare system, according to WHO.
MAT Medications and Parenting
It’s important to note that some medications — liquid methadone in particular — have a colored look in liquid form. This can be mistakenly perceived by children as a soft drink.
Also, minors looking for access to narcotics may take MAT medications with other substances and overdose, looking for a euphoria that never comes. For these reasons, parents need to exercise extreme caution if they use any of these medications.
Naltrexone-First MAT: The Best Solution for Many
It’s not an uncommon practice to take alcohol and opioids together. The CDC has found that in the past 30 days, more than 10% of the US is using at least one pain medication.
During the same time period, how many people report drinking? Not surprisingly, almost 60% of men and 51% of women report drinking in a given 30-day period. With about 55% using alcohol and 10% using painkillers in the same period of time, issues are likely to come up.
Many take alcohol with prescription opioids like oxycodone and end up in emergency rooms. Interestingly, many who end up in the ER had never taken opioids before. Being addicted to both substances simultaneously is a prescription for trouble.
Using a medication-assisted treatment plan that covers both substances acts like a two-birds-for-one-stone solution for many patients.
Naltrexone is the only medication that is an approved medication for both opioids and alcohol. It won’t have withdrawal symptoms, is non-addictive, and doesn’t have a potential for abuse or diversion.
Having an MAT recovery partner experienced in an approach that battles both substance use disorders using Naltrexone gives complete coverage. Having one that is non-addictive without physical dependence is even better.
Naltrexone doesn’t produce a “high” or euphoria, as even methadone can. There’s no withdrawal for naltrexone after it wears off or is discontinued.
Side Effects of Naltrexone
That said, there are some potential side effects to using naltrexone. It’s generally well-tolerated; however, some common complaints include:
- Nausea
- Diarrhea
- Dizziness
- Headache
- Fatigue
- Anxiety
- Insomnia
The same side effects occur with most withdrawals, so it isn’t always easy to know whether it’s because of the substance withdrawal or the medication. Doctors and counselors need to keep a close eye on the patient, in either case.
Very rarely, naltrexone does have toxic effects on the liver. Doctors often perform routine blood tests for liver function before and during treatment to determine whether this is the case for a patient.
Patients could also report depression, along with other mood disorders. This is especially true if the patient already had pre-existing anxiety that contributed to their chemical dependency in the first place.
Naltrexone and Other Medications
Most medications don’t interact with naltrexone. The best course of action is to let a physician know of all medications, OTC or prescription, that the patient takes. Naltrexone does block the effect of opioid pain relievers, so using cough and cold medications along with naltrexone could cause them to become ineffective.
A wise course of action is to carry a card in the patient’s wallet or purse that alerts medical personnel that the patient is on naltrexone. In such an event, they may choose to give alternative analgesic medications.
Also, if the patient is using a pellet-based implant, they can remove it. Then they can administer narcotics after the naltrexone is out of the patient’s system. However, this could take hours or even days.
How Long Can Someone Be on MAT?
MAT is a valuable tool in the fight against substance use disorders. However, these programs work toward a goal with a specific, outlined purpose.
Everyone has different needs, depending on the type of substance, duration of dependency, and age of the patient. Benzodiazepines, alcohol, and opioids (synthetic or natural) all affect us differently. People at different ages and durations of dependency also have different psychological profiles to consider.
Harm reduction could be the focus of the treatment for a patient with an especially high penchant for risky behavior, for example.
MAT can last from a few months to more than a year. Patients can continue to take MAT medications under a physician’s supervision for that time, up to a lifetime. The medications themselves are safe to use indefinitely.
The length of MAT is determined primarily by the patient’s needs and response to the treatment plan. Every treatment plan is crafted with the individual in mind.
It’s important to remember that MAT is not a cure for addiction. Rather, it’s a tool to help them change their lifestyle and practice principles for recovery based on their desired outcome.
Controlling cravings and symptoms of addiction that lead to relapse during the early recovery stages is the highest immediate priority. Counseling and therapy to help change behavior for a long-term solution are the furthest reaching goals. Medication on the MAT therapy plan only helps to facilitate those methods of treatment.
All three parts work together as an overall plan for managing substance use disorder now and into the future.
Medication-Assisted Treatment: Is It Your Best Shot?
A medication-assisted treatment could be your best shot to gaining and keeping sobriety. It could also be your best shot at living a healthier, more fulfilling life.
Beat Addiction Recovery addresses cravings, one of the biggest hurdles to recovery. We generally use naltrexone in our recovery program, along with other medications approved by treating physicians.
We focus on the lifelong recovery of patients using cognitive behavioral therapy, peer support platform, and medications.
Want to know what Beat Addiction Recovery can do for you or your loved ones? There’s a new plan and a new hope. Contact us today to find out how.
