This is Part 1 in our MAT series.
Summary
- Combination therapy is the use of multiple forms of treatment to treat health conditions.
- Medication-assisted therapy is a form of combination therapy that combines medication with behavioral therapy and counseling to treat substance use disorders.
- Medications for opioid use disorder include buprenorphine, methadone, and naltrexone. These medications normalize brain chemistry, prevent opioid withdrawal syndrome, block the feel-good effects of other opioids, and normalize behavior.
- MAT is a type of outpatient medical care that requires a high level of dedication from patients.
The power of combination therapy
When diagnosed with major depressive disorder (“depression”) and generalized anxiety disorder (“anxiety”) in 2016, I used an ongoing combination of counseling, prescription medication, and exercise to overcome these two mental health disorders.
Combination therapy — in which multiple treatment modalities are combined for optimal results — isn’t just for mental health. It forms the basis of the gold standard in addiction treatment: MAT!
What is MAT?
Medication-assisted treatment refers to the use of medications with behavioral therapies and counseling to treat substance use disorders — namely, opioid use disorder (OUD) and, to a lesser extent, alcohol use disorder. More recently, the approach has been used to treat stimulant use disorder in Canada.
What are MOUD?
Medications for opioid use disorder (MOUD) include buprenorphine (Suboxone®, Sublocade®), methadone, and naltrexone (Vivitrol®), all of which are opioids. These medications replace both illicit opioids (e.g., heroin, fentanyl) and prescription opioids (e.g., Vicodin, Percocet) and offer several benefits over going “cold turkey,” including:
- Normalizing brain chemistry. New research (2020) shows opioid dependency permanently changed the brains of rats.
- Preventing opioid withdrawal syndrome. Avoiding withdrawal usually becomes the number-one purpose of continued opioid use.
- Blocking the feel-good effects of other opioids. Without euphoria — or the need to avoid withdrawal — there’s no benefit of consuming opioids.
- Normalizing bodily and personal functions. When prescribed in MAT, MOUD tend not to induce the unwanted behaviors that unprescribed/illicit opioids may cause in some people.
What is MAT like?
Medication-assisted treatment is a type of outpatient care that requires frequent office visits. Facilities range from commercial office spaces to medical primary care clinics. MAT providers employ a wide range of medical and behavioral health professionals, including doctors, counselors, nurses, program directors, medical directors, and support staff (e.g., receptionists, janitors, outreach coordinators).
Maintaining enrollment requires a high level of commitment and dedication from patients. The extent of work required from each patient depends on factors like treatment history, program compliance, behavioral risk factors, overall health status, and — above all else — choice of MOUD.
Patients are routinely asked to visit their MAT providers in-person, where they submit urine samples for drug screens, attend counseling sessions, visit with program physicians, and comply with medication callbacks.
Done with this page? Move on to Part 2, Finding an MAT Provider