Medication-Assisted Treatment: The Gold Standard of Rehab

But there is one recovery option that both treats the addiction and reduces the associated harm—Medication-Assisted Therapy. MAT utilizes FDA-approved prescription medications to augment and support other treatment approaches such as education, individual counseling, and peer group therapy.  The ultimate treatment goal of MAT is completely abstinent recovery, and the medications help support the person’s continued progress while they work toward that positive outcome.

MAT is very effective—up to 70% of patients remain abstinent for a year or longer. MAT also helps patients to:

  • Stay in a treatment program longer.
  • Successfully “graduate” from rehab.
  • Refrain from using drugs or drinking alcohol during treatment.
  • Remain substance-free at follow-up: three months, six months, and one year
  • Reduce criminal behavior, arrests, and incarceration
  • Find and keep a job.
  • Have more stable relationships.

Why is MAT So Effective?

Decades of research has  shown us that chronic substance abuse affects the parts of the brain associated with  reward, pleasure, memory, learning, motivation, and impulse control. These changes impair the person’s ability to control their drinking and drug use, even when they suffer negative consequences. It becomes a compulsion that they cannot resist.

 

Just as with other chronic diseases such as diabetes, high blood pressure, or asthma, the combination of medication, individualized medical treatment, lifestyle changes, and ongoing support can arrest the progress of SUD.  And while there is no cure, the symptoms can be managed.

MAT addresses SUD the right way:

  • As a disease of the brain—Most MAT medications target the specific areas of the brain affected by substance use. Some curb cravings by replacing and blocking the effects of other, more dangerous drugs.  Others trigger a painful adverse reaction if the person uses or drinks ANY amount.
  • As a behavioral problem – True recovery is much more than simply not drinking or using drugs. Real recovery also requires emotional sobriety.  An addict in successful recovery has learned how to reduce stress, cope in a healthy manner, communicate better, and avoid triggers that could lead to relapse.

Unfortunately, MAT is not a completely-viable treatment option for every manifestation of SUD.  For example, while there are medications that can significantly reduce cravings for  heroin and other opioids, alcohol, and cocaine, there are currently no prescription meds that specifically help with cravings for benzodiazepine tranquilizers, methamphetamine, marijuana, prescription stimulants, or inhalants.

This is why psychosocial counseling and other treatment strategies are so important.

What Drugs are Used in MAT?

“Medications are the beginning of how you make the psychological change that needs to occur.”

~ Gerard Schmidt, President, Association for Addiction Professionals.

Right now, as there are over two dozen approved medications that support recovery by:

  • Alleviating withdrawal symptoms
  • Reducing cravings
  • Restoring normal brain chemistry and function
  • Correcting nutritional deficiencies

Alcohol

Abrupt, “cold turkey” withdrawal from alcohol can be fatal. This means that MAT under the close supervision of a medical specialist is always recommended.

  • Acamprosate—reduces cravings for alcohol
  • Anti-psychotics—for hallucinations and agitation
  • Baclofen—prescribed “off-label” to reduce anxiety
  • Benzodiazepine tranquilizers (Ativan, Librium, Serax, Valium, etc.)—for anxiety, confusion, and tremors, and seizures
  • Beta blockers—to reduce elevated heart rate and blood pressure
  • Carbamazepine—to regulate moods
  • Clonidine—to reduce blood pressure
  • Dilantin—to prevent seizures and convulsions
  • Disulfiram—an alcohol aversion medication
  • Folic Acid— alleviates depression
  • Gabapentin—reduces alcohol consumption
  • Naltrexone—reduces alcohol consumption
  • Phenobarbital—eases anxiety
  • Pregabalin—eases anxiety, reduces the risk of seizures
  • Propranolol—alters emotional memories
  • Thiamine—corrects nutritional deficiencies
  • Topiramate—promotes alcohol-free days
  • Varencline

Benzodiazepines

As with alcohol, abruptly quitting benzo tranquilizers is extremely dangerous.  The safest way is to gradually taper the dosage. There are currently no approved medications for benzodiazepine addiction.

Cocaine

  • Bupropion—prescribed off-label to reduce the depression of cocaine withdrawal
  • Modanifil—given off-label to reduce cocaine cravings
  • Propranolol
  • Topiramate

Opioids

  • Buprenorphine—alleviates withdrawal and reduces cravings
  • Clonidine
  • Methadone—reduces cravings and eases withdrawal
  • Naltrexone—once-monthly injections block the effects of all opioids

What Does This Mean to You?

The biggest takeaway from all of this is the fact that the treatment of addictive disorders is an evolving science.  And the more we learn about how various substances affect the brain, the better we will eventually be able to offer targeted treatment strategies and medications.

The second thing that we can learn is that there is no such thing as “one-size-fits-all” addiction treatment that is 100% of the time with 100% of the people.  This is why the best drug and alcohol rehab programs offer individualized treatment that can be tailored to the person.  Even then, adjustments often need to be made at some point during the course of treatment.

Next, although harm reduction programs provide some benefits, they are not a solution on their own for the continuing drug crisis in America.  They are more of a stopgap measure until more effective remedies can be found.

Finally, complete freedom from alcohol and drugs should be the ultimate goal of any recovery program.  Unfortunately, however, that may not always be a realistic early goal for  struggling substance abusers who are still experiencing withdrawal symptoms and powerful cravings.

Meditation-Assisted Therapy is considered the best addiction treatment option available today because it provides newly-sober, still-fragile substance abusers the help they need to overcome the cravings and withdrawal symptoms that could sabotage their successful recovery.

 

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