Is Medication-Assisted Treatment (MAT) Safe?

Medication-assisted treatment is a safe treatment method for drug and alcohol addiction withdrawal management.

MAT is used to treat opioid abuse, alcohol addiction, and tobacco use and uses a variety of evidence-based, proven treatment methods to help people overcome addiction and manage detox symptoms.

Some people have concerns over the use of medications in MAT for fear that one drug addiction will replace another. However, while there is a risk of abuse, the benefits of MAT often outweigh this potential drawback.

What Is Medication-Assisted Treatment?

MAT is a combination of behavioral therapy and medications, providing a whole-patient approach to recovery from drugs or alcohol.

Therapies used in MAT programs include:

individual therapy
group and family therapy
cognitive behavioral therapy (CBT)
motivational interviewing
dialectical behavioral therapy (DBT)
trauma-based therapy

Clients typically attend treatment daily or weekly, depending on the level of intensity and dosing schedule. Some medications are administered in daily doses, while others are given in weekly or bi-weekly batches.

MAT usually includes group sessions and relapse prevention treatment programs.

Medication-Assisted Treatment Uses FDA-Approved Medications

The types of medications used differ based on the addiction being treated. The U.S. Food and Drug Administration (FDA) has approved several medications for medication-assisted treatment.

MAT medications currently in use to treat opioid and alcohol addictions:

Buprenorphine (Subutex, Suboxone, Zubsolv, Sublocade)

Used to treat opioid abuse, buprenorphine is a partial opioid agonist, meaning it triggers opioid receptors in the brain to release small amounts of endorphins.

This produces similar effects as opioids but on a smaller scale, providing pain relief and withdrawal management.

This opiate medication has the potential for abuse, which makes some people wary of using the drug to overcome opioid addiction.

While abuse of buprenorphine medications is possible, the risk of becoming addicted to buprenorphine is still lower than other opioids, which are much more potent.

Methadone

This medication also treats opioid use disorders (OUD). Methadone is a long-acting opioid agonist and works by blocking the effects of opioids.

Methadone may be administered via mobile methadone clinics, which provide access to treatment for rural communities and underserved urban communities.

When taken as prescribed, this medication reduces cravings and is safe to use on an as-needed basis indefinitely.

However, methadone is also subject to abuse, as it is an opioid medication. But the euphoric properties of this drug are much more muted than the drug it’s being used to treat, such as heroin.

If a person attempts to get high with methadone, the effects will not be as intense as using a stronger opioid.

Naltrexone

Opioid addiction is treated with naltrexone by blocking the euphoric and sedative effects of opioids. Naltrexone can also treat alcohol abuse by producing the same euphoric-suppressing effects.

This drug essentially removes the reward of using opioids or alcohol, helping people to stop using those substances.

However, this can create issues related to drug overdose. Because naltrexone blocks the effects of opioids, if a person uses heroin or another drug, they may not realize the level of the effect and accidentally overdose.

Naltrexone may cause withdrawal symptoms in those who are physically dependent on narcotics. It’s also important to begin naltrexone treatment seven to 10 days after the last dose of an opioid drug, using the medication sooner may cause unwanted side effects.

Abuse of this medication and others can cause negative effects, but when used as prescribed, this is a safe drug to help curb opioid abuse.

Naloxone

Naloxone blocks and reverses the effects of opioids. This is used as a life-saving measure after overdose as well as a medication for MAT.

People who are prescribed naloxone have typically used high quantities of opioids for an extended time. This is a non-addictive medication that does not cause overdose and is considered very safe to use.

Acamprosate

This medication treats those recovering from alcohol addiction. It does not treat the withdrawal symptoms of alcohol, but it decreases cravings for alcohol.

Currently, there are no known long-term consequences of using Acamprosate.

Disulfiram (Antabuse)

This is an alcohol addiction treatment medication that’s ideal for people who have already detoxed from alcohol.

The drug prevents alcohol from breaking down in the body and produces unpleasant effects such as headache, nausea, and vomiting when small amounts of alcohol are consumed while using the medication.

Disulfiram is non-addictive, though it may cause some side effects such as decreased blood pressure, sweating, and vomiting. It’s also possible to overdose on disulfiram, in which case immediate medical assistance may be necessary.

When this medication is used properly, it’s completely safe as there are no known problems associated with the long-term use of disulfiram.

Are There Any Risks To Medication-Assisted Treatment?

Each of the above drugs has been fully approved by the FDA and are only available via prescription from a doctor trained to prescribe these controlled substances.

One potential risk factor is the abuse of these medications. It is possible to abuse opioid treatment medications, such as Suboxone and methadone, because these are opioid drugs.

However, there is a threshold and once that amount has been met there will no longer be any additional effects from the drug.

This is why it’s important to take these medications as a part of a larger medication-assisted treatment plan complete with evaluations, continued assessments, therapy, and other support.

If a person starts abusing their medication, the dose and administration can be adjusted.