Medically Assisted Detox
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Using Medication to Help Treat Opioid Addiction
Medication-assisted treatment (MAT) helps manage withdrawal
symptoms and reduce cravings in people who have been addicted to opioids.
This article will discuss the use of MAT to help people with
opioid use disorders, including what MAT is, how long it lasts and how much it
What Is Medication-Assisted Treatment?
MAT combines the use of medications and behavioral therapy
to treat people who have substance use disorders.11 The use of certain types of
medications has become a central part of the treatment of opioid use disorders
(e.g., heroin, Vicodin, OxyContin, etc.), tobacco use disorders, and alcohol
Medications are also used in the treatment of cocaine use
disorders, benzodiazepine use disorders, and other types of substance use
MAT is one of many options for treating opioid use
disorders. No single option is appropriate for everyone. MAT is an adjunctive
treatment or assistive therapy to the overall treatment of a person with a
substance use disorder. MAT will not “cure” the person’s addiction or ensure
success in recovery unless the person additionally engages in behavioral
treatments such as counseling, therapy, social support and long-term aftercare.
How Does MAT Help With Opioid Addiction?
People who have been abusing opioid drugs and abruptly stop
will experience withdrawal symptoms. The symptoms are so unpleasant that many
people start taking the drugs again. People in the midst of an opioid
withdrawal syndrome will also experience extreme cravings to take their drug of
MAT works to:2
Reduce uncomfortable withdrawal symptoms using an opioid
replacement medication. The medications help to lower the risk of relapse
during the early stages of recovery.
Address cravings for the drug in the early stages of
Facilitate a slow, controlled taper of the drug so that the
person can adjust to living without opioids.
Provide medical supervision of the early stages of the
person’s recovery. Supervision can be extremely helpful in addressing triggers
and potentially stressful situations that can increase the probability of
How Long Does It Last?
MAT often addresses the acute withdrawal process. However,
its length can vary. In some cases, MAT can be indefinite if the person has
serious issues with relapse.
Most of the intense withdrawal symptoms from opioid
medications resolve within a few weeks, after which the supervising physician
can initiate a tapered dosing schedule for the medication. The decision to
initiate a taper—with an MAT end-point in sight—is based on the person’s
particular circumstances, the physician’s judgment, and the input of the
Doctor sitting with patient and pointing to pill bottle
Several medications are used in medication-assisted
treatment for opioid use disorders.4 The most common medications are listed
Buprenorphine is a partial opioid agonist, which means that
it occupies the same receptors in the brain that opioid drugs target.
Buprenorphine produces similar but less pronounced opioid effects while
preventing withdrawal symptoms. When taken as prescribed, users will not get
the same “high” or the other effects of the drug they abused.
Buprenorphine can help people recover from opioid use and
avoid withdrawal. As an opioid, it does have mildly addictive properties.
However, the goal of buprenorphine treatment is not to exchange one addiction
for another. The user is first stabilized with a substance, then the dose is
Naltrexone is an opioid antagonist, which means that it
locks onto the opioid receptors in the brain and keeps other drugs from
attaching to those receptors.
It does not produce any of the effects that other opioid
drugs produce. It also blocks the “high” that users normally experience when
they use opioid drugs. This effect helps to discourage further drug use and
minimize relapse risk.
Suboxone contains both buprenorphine and naloxone, an opioid
antagonist. The combination of both drugs helps to assist with the
detoxification of opioids and has a built-in mechanism designed to make it less
prone to being abused.
Individual Differences With MAT
A person’s experience with the treatment process can vary based on:
- Medical history and substance abuse history.
- Complicating factors, such as court-ordered treatment.
- The specific opiate or opioid drug being abused.
- The physician administering the treatment.
Typically, people with extensive histories of relapse and recovery will spend longer periods of time in each of the phases. In some cases, the maintenance phase may last indefinitely. 2, 5 More serious drugs of abuse—such as heroin, Vicodin, and OxyContin—will require more attention than drugs such as codeine or tramadol, which tend to have less severe physical withdrawal symptoms.[/col][col] Because relapse is very common in all forms of substance use disorders, people who relapse at one stage of the process are encouraged to start over. For many people with substance use disorders, relapse is a learning experience that can be built upon to achieve success, as opposed to being viewed as a failure or an inability to recover from their substance use disorder.2, 5
MAT should also incorporate behavioral treatment that includes:
- An assessment of the person’s psychosocial needs.
- Individual or group counseling (or both).
- Inclusion of family support.
- Referrals to services in the community.10
- Therapies that may particular helpful for people in MAT include:
- Cognitive behavioral therapy.
- Contingency management.
- Motivational interviewing.
Benefits of Medication-Assisted Treatment
MAT offers several benefits to a person who wants to quit using opioids.2, 5
- MAT leads to a smoother transition to a drug-free lifestyle in the early stages of recovery.
- MAT can minimize withdrawal symptoms. These symptoms are associated with higher relapse rates.
- MAT can help control cravings, which are also associated with relapse.
- The treatment program and treatment team can include multiple areas of expertise and input into the treatment process.
- MAT focuses on developing skills for long-term recovery as opposed to focusing on withdrawal and detox symptoms.
- The person in MAT has a lower potential for relapse-related illnesses, legal issues, relationship issues and other social issues.
- MAT has solid empirical evidence that supports its use.1, 2, 5
MAT, particularly with opioid agonist medications, has been shown to: 10
- Reduce morbidity and mortality.
- Reduce deaths from overdose.
- Reduce infectious disease transmissions.
- Reduce criminal activity.
- Help keep people in treatment.
- Improve social functioning.
Other Types of Medication-Assisted Treatment
MAT is commonly used for opioid use disorders. But several
medications are used to help treat other substance use disorders.
Antabuse is used to treat chronic alcoholism. 6
Naltrexone is also used to treat alcohol use disorders.
Wellbutrin, an antidepressant, has been used to treat
A number of medications such a topiramate (Topamax), an
anti-seizure medication, are being investigated as potential treatments for cocaine
Other drugs such as antidepressants, anti-anxiety
medications, and analgesic medications can be used to deal with specific
symptoms from discontinuing a drug or symptoms of more chronic psychological