What Is Medication-Assisted Treatment?
Medication-assisted treatment is the use of medications in combination with behavioral and counseling therapies, providing a “whole-patient” approach to treating substance use disorders. The medications for addictions used in MAT are approved by the FDA (the Food and Drug Administration). MAT programs are clinically driven and tailored to meet each individual’s needs.
Research has shown that a combination of therapy and medication can treat disorders successfully. Some individuals who are seeking medications for addictions have found that MAT assists in sustaining recovery. MAT is also utilized to reduce or prevent opioid overdose.
Medication-Assisted Treatment For Alcohol or Opioids
MAT is primarily used for opioid addiction treatment. However, it can also be utilized as medication-assisted treatment for alcohol, along with heroin and prescription pain relievers that contain opiates. This prescribed medication operates in the following ways:
- Block the euphoric effects of opioids and alcohol
- Operates to normalize brain chemistry
- Normalize body functions without the euphoric and negative effects of the substances used
- Relieve psychological cravings
Medications For Addictions
The FDA has approved many different medications for addiction to opioids and alcohol. MAT medications relieve psychological cravings and withdrawal symptoms that cause chemical imbalances in the body. Drugs that can be used to manage substance dependence or have otherwise been considered for utilization for a part of an addiction treatment regimen are the following:
- Buprenorphine (Probuphine, Suboxone)
- Naltrexone (Vivitrol)
- Acamprosate (Campral)
- Disulfiram (Antabuse)
- Mirtazapine (Remeron)
- Modafinil (Provigil)
- Gabapentin (Neurontin)
- Bupropion (Wellbutrin, Zyban)
- Baclofen (Lioresal)
- Topiramate (Topamax)
- Vigabatrin (Sabril)
Medications For Addictions: Naltrexone and Buprenorphine
While naltrexone works by blocking opioid receptors’ activation in the brain completely, a drug like buprenorphine works by activating them partially.
The National Institute on Drug Abuse states that naltrexone works by blocking brain receptors that opioids would otherwise bind and activate to, rendering drugs incapable of eliciting their addictive high. Naltrexone is the safest when utilized after an individual has completed a medically supervised detox program. If an individual utilizes a drug used to treat addiction while opioids are still in the body, severe withdrawal symptoms can occur.
Naltrexone is considered to be an ideal drug for treating opioid use because of the following qualities:
- Minimal side effects
- Lack of abuse/addiction liability
- Ease of administration
For this reason, naltrexone is referred to as an opioid antagonist, and buprenorphine is referred to as a partial opioid agonist. When a medication is referred to as a partial opioid agonist, it means that it activates the brain’s opioid receptors but to the extent that a “full opioid agonist” like heroin does.
Naltrexone has shown applicability as a tool to treat alcoholism in patients. There is an injectable, extended-release form of Naltrexone known as Vivitrol. Vivitrol has been called “the most important breakthrough in addiction treatment in the past 25 years.” In the New York Daily News, a medical director reported that while Naltrexone requires a pill to be consumed once every day or two days, Vivitrol is administered once a month via injection. According to the director, patients felt that this administration route assisted them in staying sober.
Buprenorphine is only a partial agonist drug, and there is a “ceiling” to its opioid effects. This drug is not capable of eliciting a strong-enough high, as many full opioid agonist drugs abuse. According to the Substance Abuse of Mental Health Services Administration, the previous process lowers the degree of the withdrawal effects associated with the treatment drug itself and the potential for misuse. When Buprenorphine is utilized in this way, it can wean patients off their dependence on full opioid antagonists.
Medications For Addictions: Disulfiram and Acamprosate
When Disulfiram is prescribed, also known as Antabuse, it results in a very unpleasant reaction if the patient consumes a tiny amount of alcohol while taking this medication. Disulfiram achieves this effect by blocking a particular enzyme activity which is essential in metabolizing ethanol. The resultant buildup of Acetaldehyde, a chemical intermediary, is a problem behind the adverse physical effects.
- Vomiting and nausea
- Chest pain
- Blurred vision
- Breathing difficulties
When an individual experiences uncomfortable symptoms or knows that the symptoms will occur, it is normally thought to deter them from drinking. Acamprosate, also known as Campral, is designed specifically to maintain chemical balances in the brain that disrupts an individual pronounced with alcohol dependence. Acamprosate is another drug used to assist in alcoholic treatment.
It works by protecting the brain from overexcitation, which results in the person withdrawing from alcohol in the wake of inhibitory signaling and excitatory significant disruption. By engaging in this process, abstinence is promoted, and the likelihood is relapsed. In the journal of Alcohol and Alcoholism, a study was published that looked at 296 alcohol-dependent patients who were randomized into groups and received a placebo and Acamprosate.
The results of the experiment were that abstinence was maintained 19 days longer in the Acamprosate longer than in the placebo group. It was also found that there was continuous abstinence achieved by 35 percent of the patients’ received Acamprosate, while only 26 percent of the placebo patients attained abstinence.
Modafinil and Cocaine Dependence
In 1998, the U.S. Food and Drug Administration approved Modafinil under the name Provigil for narcolepsy treatment. Oftentimes, it’s important to remember that the fight against addiction comes from unexpected places. Modafinil is a non-amphetamine central nervous system eugeroic and stimulant. It is a drug that promotes wakefulness and alertness.
Modafinil is prescribed for individuals who struggle to function in everyday life because of diminished or irregular sleep patterns. When a person is suffering from a lack of sleep, it is typically because of the following reasons:
- Sleep apnea
- Long work shifts
The effects of this medication have drawn attention for possible Cocaine dependence treatment use. Currently, there is no FDA-approved drug. It has been speculated that the stimulant effects of Modafinil could be useful in reducing acute Cocaine withdrawal symptoms.
In addition, there is evidence showing that Modafinil may reduce Cocaine cravings and mask subjective responses to this addictive drug. When Modafinil is utilized in combination with individual behavioral therapy, abstinence can be prolonged.
This medication is primarily used for the following:
- Seasonal affective disorder
- Smoking cessation
It has been utilized as an off-label for managing attention deficit disorder and has been investigated in different types of addiction treatment as a potential role. The Primary Care Companion to the Journal of Clinical Psychiatry published a review article detailing a few of the “many uses of Bupropion.”
There were many mixed reports far from being conclusive, the author many studies that support Bupropion use for the treatment of specific types of substance abuse such as:
- Sustained release of Bupropion, such as Wellbutrin SR, combined with 12-step program participation that has the possibility to reduce Methamphetamine cravings.
This medication’s trade name is Remeron. It is mainly used to treat depression. Some limited data suggested that when Mirtazapine is combined in conjunction with therapy, that many individuals will benefit during alcohol detoxification. There is a study suggesting that this therapeutic value is achieved through the following:
- A collateral anxiety decrease
- A minimization of physical and perceived discomfort during the post-withdrawal period
- Depressive symptoms
The Other Medications for Addictions Used in Treatment
The other secluded research examples involved in pharmacotherapeutic agents include the following:
- There is research surrounding evidence that anticonvulsant medication Gabapentin might help manage particular withdrawal symptoms in an individual undergoing methadone-assisted detox.
- Baclofen is a skeletal muscle relaxant used to treat primarily muscle spasticity. It has been investigated for its possible role in opioid dependence maintenance treatment.
- A low-dose Topiramate could warrant attention for its possible role in alcohol relapse prevention that helps with the following when used in alcohol treatment dependence:
- Reducing anxiety and depression
- Reducing alcohol cravings
Why Is MAT Often Used In Detox?
One of the scariest decisions to make when deciding whether to enter treatment is undergoing detox.
The detox program depends on the following factors:
- The severity of the addiction
- The length of the addiction
For that reason, the detox process can range from mild to debilitating symptoms. Instead of an individual subjecting themselves to quitting cold turkey and undergoing cravings, MAT makes the detoxification process much more comfortable. The sole purpose of MAT is for the patient to be able to focus quickly on recovery and begin the treatment process needed.
What Withdrawal Symptoms Does MAT Treat?
During the MAT process, medications are administered to help reduce the withdrawal symptoms. The medications listed previously are utilized so slowly to wean the patients off of the drugs, so the detox process doesn’t come as a shock to their bodies. Medications are also given to assist in craving prevention.
The effective benefit of MAT is acting as the middleman in early recovery when sobriety is fragile, and relapse is likely to occur.
- Muscle aches
- Loss of appetite
- Night sweats
- Shivers or sweating
The remaining withdrawal symptoms that MAT treats are:
- Vomiting and nausea
- Stomach cramps
- Anger, Irritability, Hallucinations, Anxiety, Depression,
- Teeth chattering
Get Help At BRC Healthcare Today
We are committed to results at BRC Healthcare, and we believe in the best change to long-term sobriety. Our programs last longer than the typical rehabilitation program. To learn more on how to jumpstart recovery, contact us today.