Medication-Assisted Treatment (MAT)

Author

Kerry Nenn

About the Author

Medical Reviewer

Dr Jillian Foglesong Stabile

About the Reviewer

What is Medication-Assisted Treatment (MAT)?

Addiction is a complex issue, and treating it often requires a number of different solutions. Medication-assisted treatment (MAT) is a great example, taking the use of medications and merging those with counseling and other psychosocial methods of treatment.¹ This “whole patient” approach addresses both the chemical imbalances of addiction (the physical side) with the emotional and mental aspects (the psychological side).

Research has shown that this combination can successfully treat substance use disorders.²Taking this approach offers multiple benefits, including:

Increased survival rates: More than 106,000 people in the U.S. died from drug overdose in 2021.³ Research has shown that MAT can increase survival rates for those struggling with substance use disorders.⁴
Increased treatment retention rates: Less than 42% of individuals who enter addiction treatment complete it.⁵The use of MAT can improve these retention rates.
Better birth outcomes: For pregnant women with substance use disorders, MAT can improve birth outcomes.¹⁴
Societal benefits: The use of MAT also decreases negative societal effects of opioid or other drug abuse and increases clients’ ability to get or keep a job.

What Medications Are Used for MAT?

MAT uses FDA-approved medications to treat addiction. Acamprosate, disulfiram, and naltrexone are the most common medications used for treating alcohol use disorder. Buprenorphine, methadone, and naltrexone are the most common medications used for treating opioid use disorder.²

Acamprosate: This medication is used to treat people who have alcohol use disorders. The medicine restores the natural balance of chemicals in the brain, to reduce the desire to drink alcohol. For the drug to be effective, individuals should no longer be drinking when they start taking it.⁶
Disulfiram: This medication is used to treat alcohol use disorder. It stops the body from properly processing alcohol, so people who are taking it have bad physical reactions if they drink alcohol (headache, vomiting, chest pain, sweating, weakness, and other unpleasant symptoms).⁸
Buprenorphine: This drug is a partial opioid agonist, meaning it activates the same receptors as opioids, but in a different way. Instead of providing a “high,” it eases cravings for opioids and alleviates withdrawal symptoms.⁷
Methadone: This substance is used to treat opioid use disorder. It is a long-acting full opioid agonist, which means it blocks or reduces the effects of opioids while also reducing cravings. It is available in diskette, powder, and liquid formats.⁹
Naltrexone: This medication is used for the treatment of both opioid use disorder and alcohol use disorder. Naltrexone works by blocking the euphoric and sedative effects of opioids and alcohol. It reduces cravings for these substances.¹⁰
Suboxone: One of the main medications used to treat opioid addiction, Suboxone is a combination of buprenorphine and naloxone. The buprenorphine works by filling the brain’s opioid receptors, reducing opioid withdrawal symptoms, and reducing cravings. Meanwhile, naloxone blocks the euphoric effects of opioid drugs, should someone attempt to misuse Suboxone or take other opioids. This essentially provides an extra layer of protection against relapse. Suboxone comes in an oral film or an oral tablet, both of which can be dissolved under the tongue (sublingual).

Is MAT an Effective Treatment for Addiction?

Per the Substance Abuse and Mental Health Services Administration (SAMHSA), MAT is considered the “gold standard” of treatment. It has shown to be effective in clinical studies to decrease the need for inpatient detox, reduce the rate of relapse, and lower the risk of contracting HIV and Hepatitis C.

Research reveals the effectiveness of MAT on multiple fronts:

Medication-assisted treatment (MAT), reduces the death rate among those living with addiction by 50% or more.¹¹
Up to 90% of patients who use MAT maintain sobriety at the 2-year mark.¹¹
MAT reduces the chance of relapse, criminal activity, and transmission of infectious diseases.¹¹
MAT is associated with fewer inpatient admissions for individuals with alcohol use disorder.¹⁰
Healthcare costs are up to 30% less for individuals receiving MAT than for those not receiving MAT.¹⁰

What Therapies Are Utilized in MAT Programs?

When patients receive medication-assisted treatment (MAT), they also participate in various therapies to treat their substance use disorder. Methods vary by treatment program, but the most common therapies include:¹³

Cognitive Behavioral Therapy

Also known as CBT, this is the most common type of behavioral therapy. Goal-oriented, the therapy aims to help clients identify goals and achieve them. This is accomplished by recognizing and replacing unhealthy thought patterns, developing stress-reduction skills, preparing for difficult situations, and facing fears.

Rational Emotive Behavior Therapy

REBT focuses on identifying and replacing irrational beliefs and coping with the feelings that come with irrational beliefs. The goal is to help clients recognize beliefs they hold that are not realistic and adopt more realistic beliefs. Common coping strategies used in REBT include exercise, meditation, and journaling.

Contingency Management

Contingency Management (CM) rewards patients for positive behaviors. This happens through either voucher-based reinforcements (VBR) or prize incentives (PI). VBR rewards can be exchanged for tangible items such as gift cards. If PI is used, clients draw from a bowl to receive a cash prize of up to $100. The more changes the client makes, the more draws they can make.

Motivational Interviewing

Motivational Interviewing (MI) is used to help patients overcome fear of change and conflicting emotions. It helps motivate participants to change substance-use-related behaviors.

Family and/or Couples Therapy

This type of therapy may include private sessions and group sessions with the therapist. The goal is to address the needs of both partners or the entire family. This method incorporates CBT to identify and change unhealthy behaviors.

How Much Does Outpatient MAT Cost?

The cost of outpatient MAT programs vary by location and program, with general outpatient rehab costs ranging from $1,400 to $10,000. Based on national averages for MAT, you can expect to pay around $126 per week for methadone, $155 per week for buprenorphine, and $1,177 per month for Naltrexone.¹³

Fortunately, various insurance plans offer coverage for this treatment.

Private Insurance: The Mental Health Parity and Addiction Equity Act of 2008 requires insurance companies to provide the same benefits for substance use treatment that they do for medical care.¹³
Medicaid: As of 2020, all state Medicaid plans must cover FDA-approved drugs for opioid addiction treatment.¹²
Medicare: Medicare may cover MAT. However, you may have to meet certain requirements and/or be enrolled in Medicare Part B.¹²Generally, Medicare Part A covers inpatient services, and Medicare Part B adds coverage for outpatient services.

Is Medication-Assisted Treatment Right for You?

Individual needs vary. Treatment plans vary. MAT may be a better fit for some people than others. To determine if MAT is right for you, consider:

It reduces the danger of withdrawal.

Symptoms of withdrawal can be severe and even life-threatening. Using MAT can lessen the severity and reduce the dangers of withdrawal. If you have a long-term addiction, MAT may be necessary to alleviate symptoms and help you step away from substance abuse safely.

It can bridge a gap.

When you complete a rehab program, MAT can bridge the gap between rehab treatment and independent living. Once you leave the clinical setting, it can be difficult to maintain sobriety. MAT may be able to help you ease back into life with continued recovery support that doesn’t require direct monitoring or supervision.

It’s not for everyone.

To receive MAT, you must pass a screening and assessment to determine if the treatment is suitable for your health and situation. Candidates for medication-assisted treatment must have an official substance use disorder diagnosis and be willing to follow prescription instructions. Additionally, they must not have any physical problems that the medication could worsen.

It’s not an instant cure.

MAT takes time to take effect. The amount of time required for it to work depends on the severity of your addiction. You may need to continue MAT for several months for it to be effective long-term. For some people, it may be a year before they can live a drug-free life. However, most people only need one to three months of MAT to effectively treat their substance use disorder.

Resources

Information about medication-assisted treatment (MAT). U.S. Food and Drug Administration. Retrieved May 16, 2023, from https://www.fda.gov/drugs/information-drug-class/information-about-medication-assisted-treatment-mat
Medications for substance use disorders. (n.d.). SAMHSA. Retrieved May 16, 2023, from https://www.samhsa.gov/medications-substance-use-disorders
Drug overdose death rates. (2023, February 9). National Institute on Drug Abuse. https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates
Ma, J., Bao, Y.-P., Wang, R.-J., Su, M.-F., Liu, M.-X., Li, J.-Q., Degenhardt, L., Farrell, M., Blow, F. C., Ilgen, M., Shi, J., & Lu, L. (2019). Effects of medication-assisted treatment on mortality among opioids users: A systematic review and meta-analysis – PubMed. Molecular Psychiatry, 24(12). https://doi.org/10.1038/s41380-018-0094-5
Acamprosate oral: Uses, side effects, interactions, pictures, warnings & dosing. (n.d.). WebMD. Retrieved May 16, 2023, from https://www.webmd.com/drugs/2/drug-91488/acamprosate-oral/details
Buprenorphine for opioid use disorder. (n.d.). WebMD. Retrieved May 16, 2023, from https://www.webmd.com/mental-health/addiction/opioid-use-disorder-buprenorphine
Disulfiram oral: Uses, side effects, interactions, pictures, warnings & dosing. (n.d.). WebMD. Retrieved May 16, 2023, from https://www.webmd.com/drugs/2/drug-1446/disulfiram-oral/details
Methadone. (n.d.). SAMHSA. Retrieved May 16, 2023, from https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions/methadone
Naltrexone. (n.d.). SAMHSA. Retrieved May 16, 2023, from https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions/naltrexone
10 Things You Need to Know About Medication-Assisted Treatment. (n.d.). South Dakota Departments of Health and Social Services.
Iowa Department of Public Health. (n.d.). Medication assisted treatment (MAT). Retrieved May 16, 2023, from https://hhs.iowa.gov/sites/default/files/MHDS-Medication-Assisted-Treatment-Powerpoint.pdf
(DCD), D. C. D. (2018, April 18). Does insurance cover treatment for opioid addiction? https://www.hhs.gov/opioids/treatment/insurance-coverage/index.html
How much does opioid treatment cost? (n.d.). National Institute on Drug Abuse. Retrieved May 16, 2023, from https://nida.nih.gov/publications/research-reports/medications-to-treat-opioid-addiction/how-much-does-opioid-treatment-cost
England CN. (2019) MAT Offered for Pregnant Women with Opioid Use Disorder. Women & Infants. https://www.womenandinfants.org/news/mat-offered-for-pregnant-women-with-opioid-use-disorder.