Challenging the Myths About Medication Assisted Treatment (MAT) for Opioid Use Disorder (OUD)
MAT bridges the biological and behavioral components of addiction. Research indicates that a combination of medication and behavioral therapies can successfully treat SUDs and help sustain recovery.
Research shows that patients on MAT for at least 1-2 years have the greatest rates of long-term success. There is currently no evidence to support benefits from stopping MAT.
MAT utilizes a multitude of different medication options (agonists, partial agonists, and antagonists) that can be tailored to fit the unique needs of the patient.
MAT helps to prevent overdoses from occurring. Even a single use of opioids after detoxification can result in a life-threatening or fatal overdoes. Following detoxification, tolerance to the euphoria brought on by opioid use remains high than tolerance to respiratory depression.
MAT has been shown to assist patients in recovery by improving quality of life, level of functioning and the ability to handle stress. Above all, MAT helps reduce mortality while patients begin recovery.
MAT is evidence-based and is the recommended course of treatment for opioid addiction. American Academy of of Addiction Psychiatry, American Medical Association, The National Institute on Drug Abuse, Substance Abuse and Mental Health Services Administration, National Institute on Alcohol Abuse and Alcoholism, Centers for Disease Control and Prevention, and other agencies emphasize MAT as first line treatment
As of May 2013, 31 stat Medicaid FFS programs cover methadone maintenance treatment provided in outpatient programs. State Medicaid agencies vary as the whether buprenorphine is listed on the Preferred Drug List (PDL), and whether prior authorization is required (a distinction made based on the specific buprenorphine medication type). Extended-release naltrexone is listed on the Medicaid PDL in 60 percent of states.
Medications for Treating Opioid Dependence
Common Brand Names
Effect
Formulations
Frequency
Administration
When to Begin
Buprenorphine
Suboxone, Bunavail and Zubsolv (all Buprenorphine with Naloxone), Generic Buprenorphine, Generica Buprenorphine with Naloxone
Prevents withdrawal symptoms and reduces cravings, but without obtaining a high.
Pill (generic buprenorphine or generic buprenorphine with naloxone, or Sublingual Film (Suboxone)- a film placed under the tongue and kept there until it’s dissolved.
Generally daily or twice a day
Buprenorphine can be accessed in an office-based treatment setting from a certified physician or federally-licensed opioid treatment program.
Should be started when mild to moderate opioid withdrawal occurs. Taking it too soon can make withdrawal worse.
Naltrexone
ReVia, Vivitrol, Depade
Treats addiction by blocking the effect of opioid drugs. Particularly helpful in preventing relapse.
Pill, Depot Injectable (gradual release)
Pill- taken daily: Depot Injectable (gradual release)- administered every 30 days.
Can be accessed in all treatment settings.
Cannot be taken until opioids are completely out of the body, usually 7-10 days after withdrawal beings. Taking it too soon can make withdrawal worse.
Methadone
Generic Methadone
Prevents withdrawal symptoms and reduces cravings, but without obtaining a high.
Pill, Liquid, Injectable
Taken daily
Can only be accessed and administered in a federally-licensed opioid treatment program (OTP).
Should be started when mild opioid withdrawal is present. Initial does should be low and carefully monitored to avoid sedation and/or overdoes.