According to the Substance Abuse and Mental Health Services Administration (SAMHSA),
“Medication Assisted Treatment (MAT) is the use of FDA- approved medications to treat alcohol and opioid addiction, in combination with counseling and behavioral therapies, to provide a ‘whole-patient’ approach to the treatment of substance use disorders. Research shows that a combination of medication and therapy can successfully treat these disorders, and for some people struggling with addiction, MAT can help sustain recovery.”
Recent study results show that this type of treatment keeps clients in therapy or treatment longer. It reduces illicit drug use and overdoses. It even decreases crime and disease rates.
MAT does not refer only to ‘maintenance’ drugs such as methadone. Examples of other FDA-approved medications used in MAT include:
- Buprenorphine (Suboxone, Subutex, and Zubsolv®)
- Naltrexone (ReVia, Vivitrol, and Depade)
- Disulfiram (Antabuse), and
- Acamprosate Calcium (Campral)
MAT Works – But Had an Uphill Battle to Common Treatment Center Use
SAMHSA says that, “MAT for substance use disorders has proven to be clinically effective… However, it is greatly underutilized. A 2011 study found that less than 30% of contemporary substance use treatment programs offer medications; and less than half of eligible patients in those programs actually receive medications.”
Barriers to use of MAT include lack of available prescribers and lack of support for existing subscribers, agency policies that prevent MAT use, workforce attitudes, insurance issues, such as limits on MAT, authorization requirements, and “fail first” criteria that require treatment programs to try other therapies first. If all of those fail, then they can use MAT.
Although it is an evidence-based therapy, MAT has long been a hot topic in the recovery community…even in the field of treating substance use disorders (SUD) or providing SUD support services. For example, many sober living home programs did not allow people on methadone or other maintenance drugs to live in their houses, furthering the stigma of drug-assisted therapy, and preventing people who were trying to change their lives from easily accessing a stable, supportive living environment.
Some of those attending 12-step self-help groups did not consider a person utilizing MAT truly “clean and sober.” I used to hear things in meetings such as, “You’re just substituting one drug for another!”
MAT Adoption is Growing Over Time
Fortunately, education about advances in the field of SUD treatment have helped dispel this stereotype as does reference to 12-Step approved publications such as “The A.A. Member – Medications and Other Drugs,” which emphasizes that, “no A.A. member should ‘play doctor’; all medical advice and treatment should come from a qualified physician.”
As pointed out by Dr. Louis E. Baxter in an article published by the American Society of Addiction Medicine in June 2014 entitled, Twelve Step Recovery and Medication Assisted Therapies, it eventually became clear to those in the treatment field that it is just as wrong to deprive someone of medication that can help control their addiction as it is to enable or support them to become re-addicted to a drug.
Dr. Baxter goes on to say, “Although there is no dispute that abstinence from alcohol and other drugs with potential for addiction is the foundation for sustaining recovery in most instances, there are other cases where MAT, especially for persons with co-occurring illnesses, is essential to obtain and sustain term recovery.”
While medication assisted therapy (MAT) is now more widely accepted, it is important to continue making advances and be aware that not everyone recovers in the same way. Long ago we discovered that “cookie cutter” treatment doesn’t work. Individualized treatment and supports tailored to the needs of each individual DOES work.
Here are some great references if you’re interested in reading more about MAT:
- The AMA and AAFP Urge Removing All Barriers to Treatment for Substance Use Disorder (PDF)
- The Case for MAT (Pew)
- SAMHSA-HRSA Center for Integrated Treatment – MAT Overview
- Expanding the Use of Medications to Treat Individuals with SUD in Safety Net Settings: Creating change on the ground: Opportunities and lessons learned from the field (SAMHSA)
- Twelve Step Recovery and MAT (ASAM)