Medication-Assisted Treatment for Alcohol and Opioid Addiction

Medical Reviewer

Sendra Yang

About the Reviewer

Medication-assisted treatment (MAT) is a form of addiction treatment that combines counseling and addiction medication to provide comprehensive care, reduce the risk of relapse, and mitigate cravings. Medication-assisted treatment is available for both opioid use disorder and alcohol use disorder.

In this article:

What is Medication-Assisted Treatment (MAT)?

Medication-assisted treatment for drug addiction is a useful tool in the recovery process. MAT is the term used for medications that are approved by the Food and Drug Administration (FDA) to help treat the effects of a substance use disorder (SUD).¹ These medications are intended to be used alongside behavioral therapies as a comprehensive approach to treating your alcohol or opioid use disorder.

Therapy can be a taxing process for anyone. Engaging in weekly sessions where you explore your thought and behavior patterns is hard work and requires mental focus and emotional resilience. MAT helps to ensure that you are mentally and physically able to participate in these therapy processes in the most effective way.

How is Medication-Assisted Treatment Used?

Medication-assisted treatment is used as an option for those who have an alcohol use disorder (AUD) or opioid use disorder (OUD). The medication interacts with the chemicals in your brain to help:2

Reduce cravings for the substance
Block the euphoric effects of substances
Improve your health and well-being
Maintain proper functioning in relationships and life responsibilities

MAT is used in conjunction with therapies within an environment that is driven by clinical expertise. Your treatment team will assess your specific needs and tailor the medication and therapeutic interventions to your situation.

Medication should be combined with therapy as a way to reduce the risk of relapse. Therapy, such as cognitive behavioral therapy (CBT), will help you identify thoughts and behaviors that lead to substance use so you can address them effectively. It also helps you find motivational factors that will help you cope with triggers as they arise during or after treatment. These coping skills are essential to the recovery process.

Who is a Candidate for MAT?

The FDA has approved certain medications to treat opioid and alcohol use disorders.1 Medication-assisted treatment is not always the recommended route or option for everyone with one of these disorders. You may be a candidate for MAT if:^1,2

You have a moderate to severe alcohol or opioid use disorder
You have a co-occurring mental health condition
You have tried to stop using alcohol or opioids but were unable to do so
You have a history of relapse or overdose

If you are unsure if MAT is the right option for you, talk to your healthcare provider to get an assessment and recommendations.

Medication-Assisted Treatment for Opioid Use Disorder

A study done in 2016 found that more than 2 million people in the United States had an OUD.3 The opioid crisis is an ongoing issue in America that healthcare providers are continuously studying and trying to remedy. The FDA has approved three drugs to treat OUD, which are buprenorphine, methadone, and naltrexone. The FDA considers these medications to be a necessary treatment option for OUD in combination with counseling and psychosocial support.⁴

These medications are often used long-term to treat OUD, and you could even be on one of these medications indefinitely as a way of managing OUD over your lifetime. Relapse is a common part of the recovery process, and MAT helps in reducing your risk of relapse.

Buprenorphine

Buprenorphine is the first of the three FDA-approved drugs used to treat OUD that can be prescribed and dispensed in your doctor’s office as opposed to an opioid treatment program (OTP).5 This means you have easier access to the drug than other treatments.

Buprenorphine works as an opioid partial agonist, meaning it attaches to the same opioid receptors in your brain as opioid drugs but has weaker effects. When taken as prescribed, buprenorphine is safe and effective and can help by:⁵

Alleviating withdrawal symptoms and reducing cravings for opioids
Providing a level of safety in the instance of overdose due to its increased effects stopping at a moderate dose
Reducing your risk of misusing opioids by limiting euphoric effects

To take buprenorphine, you have to abstain from using opioids for at least 12 to 24 hours in order to avoid acute withdrawal, which can happen when opioids are still in your bloodstream.5 Your treatment team will determine your dosage and how long you need to take buprenorphine to treat OUD and prevent a possible relapse.

Methadone

Methadone is another FDA-approved medication used to treat OUD. Methadone is a long-acting opioid agonist, which means it also attaches to the opioid receptors in your brain, but at lower doses that can help to reduce opioid cravings and lessen or block the effects of opioids.⁶

You can only receive methadone treatments under the supervision of a medical professional at a methadone clinic. However, you may be able to take methadone at home after a period of time showing compliance with dosage and following treatment recommendations.

The general recommendation for methadone treatment is a minimum of 12 months, though you may take the medication for longer or even indefinitely.6 If you or your treatment provider decides to end your methadone treatment, a gradual tapering of the dosage is needed to avoid methadone withdrawal symptoms.

Suboxone

Suboxone is the combination of buprenorphine, a partial opioid agonist, and naloxone, an opioid antagonist. Opioid antagonists block the effects of opioids in your brain. This means that Suboxone can help stop cravings and even block the euphoric effects of opioids if you do take them again, which aids in preventing relapses. The addition of naloxone to buprenorphine can deter misuse by causing opioid withdrawal in someone who injects this medication. Only specialized Suboxone doctors can prescribe this opioid addiction medication.

Medication-Assisted Treatment for Alcohol Use Disorder

Three main drugs are used in medication-assisted treatment for alcohol use disorder. These medications are acamprosate, disulfiram, and naltrexone.

Acamprosate

Acamprosate is a drug that is used to help prevent relapses in alcohol use. If you have stopped drinking alcohol and have been abstinent for at least five days, you can start taking acamprosate to help decrease cravings and urges to drink alcohol so you can stay abstinent. However, this drug does not help alleviate withdrawal symptoms and has not shown to be effective if you continue drinking or using other substances.⁷

Disulfiram

Disulfiram is another medication approved by the FDA to treat AUD. This drug works by causing unpleasant effects when you drink alcohol so as to discourage you from using the substance. Some of the effects you will feel after drinking alcohol if you are also taking disulfiram include:⁸

Feeling hot or flushed in the face
Headaches
Stomach discomfort including nausea and/or vomiting
Chest pain
Muscle weakness
Blurred vision
Confusion
Excessive sweating
Choking
Difficulty breathing
Increased anxiety

Naltrexone

Naltrexone is a drug used to treat both OUD and AUD. Your doctor will wait until you are detoxed from alcohol or opioids before giving you naltrexone to avoid side effects like nausea and vomiting.

Naltrexone works by attaching to the endorphin receptors in your brain and blocking the effects of alcohol or opioids.⁹ It helps to reduce cravings and maintain your sobriety after you have stopped taking substances. This drug is usually used in treatment for three to four months.

How Effective is Medication-Assisted Treatment?

Medication-assisted treatment has shown to be effective in several studies over the years. Research shows that MAT:¹

Improves chances of surviving a SUD
Decreases illegal opioid use and other criminal activity
Improves your ability to gain and maintain employment
Increases your chances of staying in treatment
Provides better birth outcomes for pregnant people who have SUD
Lowers risk of HIV and Hepatitis C
Reduces risk of relapse

Finding Medication-Assisted Treatment Programs

If you are considering a medication-assisted treatment program, the first step is to talk to your primary care provider. Medical professionals are trained to do a thorough assessment of your condition and make recommendations on the best treatment for your situation.

Once you know what kind of treatment you are looking for, you can ask your doctor for help in finding the right treatment center. Contacting your insurance provider, if you have one, is also a helpful step in finding a MAT program. Most insurance will cover at least some of the costs of a rehab program. You can also speak to the treatment facility directly to discuss payment options.

If you or someone you know has alcohol or opioid use disorder, please call 800-914-7089 (Who Answers?) to get help today.

Resources

1. Substance Abuse and Mental Health Services Administration. (2022, March 30). Medication-Assisted Treatment (MAT). United States Department of Health and Human Services.
2. Texas Health and Human Services. (n.d.). Adult Substance Use Medication-Assisted Treatment.
3. Centers for Disease Control and Prevention. (2019, June 17). Medication-Assisted Treatment for Opioid Use Disorder Study (MAT Study) | CDC’s Response to the Opioid Overdose Epidemic. United States Department of Health and Human Services.
4. United States Food and Drug Administration. (2019, February 14). Information about Medication-Assisted Treatment (MAT). United States Government.
5. Substance Abuse and Mental Health Services Administration. (2022, March 4). Buprenorphine. United States Department of Health and Human Services.
6. Substance Abuse and Mental Health Services Administration. (2022, April 13). Methadone. United States Department of Health and Human Services.
7. Substance Abuse and Mental Health Services Administration. (2022, March 4). MAT Medications, Counseling, and Related Conditions. United States Department of Health and Human Services.
8. National Library of Medicine. (2017, August 15). Disulfiram: MedlinePlus Drug Information. National Institutes of Health.
9. Substance Abuse and Mental Health Services Administration. (2022, April 4). Naltrexone. United States Department of Health and Human Services.

Medical Reviewer

Sendra Yang

About the Reviewer