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Medication-Assisted Treatment for Opioid and Alcohol Dependency

Medication-assisted treatment (MAT) involves the use of FDA-approved medications and behavioral therapies to treat people suffering from substance use disorder. While traditional treatment approaches focus solely on therapeutic interventions, MAT programs in North Carolina integrate pharmacotherapy and medication management into the treatment plans of people with opioid or alcohol addictions. By combining medication and behavioral therapy, addiction treatment providers offer a “whole-patient” approach to care.

Some of the most common medications used in medication-assisted treatment programs include:

  • Suboxone (buprenorphine/naloxone)
  • Sublocade (buprenorphine)
  • Vivitrol (naltrexone)

Patients who experience withdrawal symptoms while in detox may be prescribed one of the above medications or any other necessary prescription and over-the-counter drugs. During detox, medications help ease withdrawal symptoms and curb cravings, making for a more comfortable and safe withdrawal process. However, these medications also assist patients during early recovery by reducing the risk relapse and increasing treatment retention rates.

It is important to note that the use of medications alone is not a cure for drug or alcohol addiction. Instead, they exist to assist an individual who is actively participating in a comprehensive addiction treatment program.

What is Medication-Assisted Treatment (MAT)?

Medication-assisted treatment programs in North Carolina are primarily aimed at people who are addicted to opioids such as oxycodone, heroin, or fentanyl. However, some patients who suffer from alcohol use disorder may benefit from MAT as well. The medications prescribed during treatment help normalize brain chemistry and body functions, reduce drug cravings, and block the euphoric effects of opioids and alcohol.

All medications that are used during MAT are approved by the Food and Drug Administration (FDA). While these medications are generally safe and effective when used correctly, physicians don’t recommend mixing them with anxiety treatments or benzodiazepines like Valium, Klonopin, or Xanax. Furthermore, providers who are offering opioid treatment programs (OTPs) must be accredited by a SAMHSA-approved body and abide by federal guidelines.

Federal law requires that patients who are enrolled in MAT programs must receive counseling that involves several different forms of behavioral therapy. Additional services that are offered to all MAT patients include medical, vocational, and educational assistance.[1] Whether a patient is enrolled in inpatient or outpatient rehab, he or she will participate in both group and individual therapies in order to learn how to identify destructive behaviors and thought patterns. As a result, therapists can help patients learn more constructive coping mechanisms as well as assist patients in working through traumas or co-occurring disorders that may affect their recovery.

Medications Used for Opioid Addiction Treatment

There are currently three FDA approved medications used to treat opioid dependency or opioid use disorder. These include methadone, buprenorphine, and naltrexone.

Methadone

Methadone was the first opioid abuse prescription medication, but it is the least commonly used today. The drug is used to relieve severe pain and alleviate opioid withdrawal symptoms. Methadone is an opiate analgesic that works to change the way the brain and nervous system perceive and respond to pain. In doing so, it prevents severe withdrawal symptoms and cravings in people who are dependent on opioid drugs.[3] However, due to the medication’s high risk potential for abuse, it is not prescribed as often as other medications like buprenorphine.

Buprenorphine

Buprenorphine is a partial opioid agonist that prevents withdrawal symptoms and drug cravings in people who are addicted to opioids. It does this by binding to opioid receptors in the brain and blocking them from feeling the effects of other opioids. Buprenorphine is available in several different forms and is one of the most commonly used medications for opioid treatment. The different types of buprenorphine products on the market are:[4]

  • Subutex – sublingual tablet containing buprenorphine
  • Suboxone – sublingual film containing buprenorphine/naloxone
  • Sublocade – extended-release injection containing buprenorphine
  • Zubsolv – sublingual tablets containing buprenorphine and naloxone
  • Bunavail – buccal film containing buprenorphine and naloxone

Buprenorphine is often prescribed with naloxone in order to help prevent prescription misuse.

Naltrexone

Naltrexone is an opiate antagonist that prevents the effects of opioids and decreases the desire to consume opiates. The medication may come in a pill form or as an extended-release injection known as Vivitrol. Naltrexone is also used to treat alcohol use disorder.[5]

Medications for Treating Alcohol Abuse

In addition to naltrexone or Vivitrol, patients who suffer from alcohol use disorder may be prescribed disulfiram or acamprosate to help treat their condition.

Disulfiram

Patients who have already completed detox may take disulfiram along with counseling and peer support for the treatment of alcoholism. Disulfiram, sold under the brand name Antabuse, stops the processing of alcohol in the body causing people to have a bad reaction when they drink. This can help deter alcohol abuse.

Acamprosate

Acamprosate is also for people who have stopped drinking and want to avoid drinking in the future. Sold under the brand name Campral, acamprosate helps restore balance to the mind and body, ultimately reducing alcohol cravings. Unlike Antabuse, people who drink while taking Campral will not get sick.

Behavioral Therapy and Peer Support

The medications used in MAT programs serve only to assist in the addiction treatment process. After all, none of the above mentioned medications provide a cure for drug or alcohol addiction. Instead, they help aid the patient by reducing withdrawal symptoms and drug cravings. While taking these medications, patients should participate in a comprehensive addiction treatment program that consists of behavioral therapy and peer support.

During treatment, patients will participate in group and individual therapies to help get to the root causes of their substance abuse. Without having to battle constant cravings or lingering withdrawal symptoms, patients are able to focus fully on their recovery. Addiction treatment programs in North Carolina will also address co-occurring disorders, underlying trauma, and unhealthy coping mechanisms. With the help of therapy and intensive counseling, patients are able to learn how to cope with cravings and sustain their sobriety without the use of medications.

Therapies and activities that patients may participate in while in at MAT program include:

  • Cognitive behavioral therapy (CBT)
  • Dialectical behavior therapy (DBT)
  • Motivational interviewing
  • Trauma-informed care
  • Dual diagnosis treatment
  • Holistic therapy
  • Recreational therapy
  • 12-step facilitation
  • Family therapy

Medication-assisted treatment programs also encourage peer support. In most cases, recovery doesn’t stop after a person leaves rehab. Instead, they must continue treating their addiction on a daily basis by participating in a 12-step fellowship, alumni group, or other form of sober support. When a person eventually comes off of their medications, he or she should have a support group to rely on in order to prevent relapse.

Benefits of Medication-Assisted Treatment Programs

Nearly 130 people die from an opioid-related overdose in the United States every day. In North Carolina alone, there were 1,783 fatal opioid related overdoses in 2018.[2] With the opioid epidemic still ravaging the nation, it’s important that people have access to the most effective addiction treatments available.

Medication-assisted treatment provides patients with a comprehensive and individualized approach using a combination of medication and behavioral therapy. It also aims to provide the necessary support services for people in recovery. As a result, there are many benefits associated with MAT programs, including:[1]

  • Increased treatment retention rates
  • Improved patient survival after treatment
  • Decreased rates of illicit opiate use after rehab
  • Improved birth outcomes in pregnant women who are addicted to opioids
  • Decreased rates of criminal activity among people who are addicted to opioids
  • Improved patient ability to obtain and keep a job
  • Reduced risks of contracting HIV or hepatitis C and other common comorbidities
  • Decreased risk for relapse after completing treatment

Despite the many benefits of medication-assisted programs, MAT isn’t for everyone. Instead, you should speak with your healthcare provider or an addiction specialist to figure out which type of treatment is best for you.

Get Started With Medication-Assisted Treatment in North Carolina Today

Located in Charlotte, North Carolina, our CARF Gold Seal accredited drug and alcohol rehab center proudly offers medication-assisted treatment to individuals battling opioid and alcohol addiction. We know just how difficult early recovery can be, but we also have the tools, resources, and expertise to help you get through it. If you or a loved one are ready to get started on a better life, contact a trusted addiction specialist today.

References:

  1. https://www.samhsa.gov/medication-assisted-treatment/treatment
  2. https://www.drugabuse.gov/drug-topics/opioids/opioid-summaries-by-state/
  3. https://medlineplus.gov/druginfo/meds/a682134.html
  4. https://medlineplus.gov/druginfo/meds/a605002.html
  5. https://www.webmd.com/drugs/2/drug-7399/naltrexone-oral/details

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