Traditionally, drug and alcohol addiction treatment involves abstinence, behavioral therapy, and therapy. It does not traditionally involve other drugs. However, some traditions inevitably fade away, and in the case of drug and alcohol addiction treatment, the tradition is currently fading. Medication assisted treatment (MAT) combines the traditional method with the use of medications. MAT is most commonly applied to opioid addiction treatment, but has proven to be effective for alcohol addiction treatment as well.
The idea of including medicine in addiction treatment is not new. Methadone was developed in the 1930s and introduced to the US in 1947. Marketed initially as a kind of cure-all for anything painful, methadone was soon recognized as a powerful tool in addiction treatment. Methadone treatment is essentially drug replacement, except the addict will not feel high from methadone, only satisfied chemically. Combine this with traditional forms of addiction treatment, and you have MAT.
A History of Success
In 1994, the California Department of Alcohol and Drug Programs conducted a study on substance abuse treatment. The study mainly focused on the costs of treatment, however one of the findings of the study reads: “Patients in methadone maintenance showed the greatest reduction in intensity of heroin use, down by two-thirds, of any type of opioid addiction treatment studied.”
Methadone remains the most popular medication for opioid addiction treatment. While effective, regarding MAT, some other less-addictive medications are also utilized:
- Buprenorphine – Similarly to methadone, this is an opioid agonist, which means it blocks the effects of opioids in the brain. The user will not feel high, but will have their bodily craving of opioids taken care of. Buprenorphine is much less addictive than methadone, and has been proven to be nearly as effective, with fewer side effects.
- Naltrexone – This is also an opioid agonist, but has proven to be effective in treating alcoholism as well. Regarding its use with alcoholism, because of the constant availability of alcohol, there is an injectable form of naltrexone called Vivitrol, which lasts for a month between injections.
- Disulfiram – Approved by the FDA in 1951 and still effective today, this medication prevents alcohol breakdown in the liver, causing the user to vomit any and every time alcohol is consumed. The medication is rather effective for obvious reasons, but can be damaging to the esophagus (again for obvious reasons). Disulfiram is currently being studies as a possible treatment for cocaine addiction as well.
- Acamprosate – Used primarily to combat alcoholism, this medication reduces the cravings for alcohol. It is a newer drug, (FDA approved in 2004), and is used similarly to Disulfiram, except acamprosate will not induce vomiting upon the consumption of alcohol.
The Harvard Medical School Study
Less than one year ago, the results of a long-term study on medication assisted treatment were published. Harvard Medical School, as well as McLean Hospital, led the study over the course of three and a half years. Buprenorphine was the medication applied, and the group consisted of over 650 opioid-based painkiller addicts. The results, according to Dr. Roger Weiss, one of the study’s conductors, “are cause for optimism,” and according to Dr. Jennifer Potter, the results “represent an important first step toward understanding the course of dependence on opioid pain relievers, and for identifying factors associated with longer-term recovery.”
After 18 months of MAT, here are some pertinent results from the study:
- Over half of the patients (51.2%) reported abstinence after 18 months.
- Nearly two-thirds (61.4%) of the patients reported abstinence after 42 months.
- After 42 months, less than 10% of patients were scientifically diagnosable as dependent.
- Patients not involved in MAT but rather in traditional treatment reported much less success.
With proper administration and regulation, medication assisted treatment proves to be more effective than non-medicated treatment. Steps are being taken in the right direction. More and more professionals every day are recognizing the benefits of MAT.
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