What Is Medication-Assisted Therapy?

According to the Substance Abuse and Mental Health Services Administration (SAMHSA) and numerous other professional sources, medication-assisted therapy or medication-assisted treatment (MAT) refers to the process of combining behavioral treatments and medicines in the treatment of substance use disorders.

 

There are no medications that can cure substance use disorders. Instead, medications are used to help in the treatment of substance use disorders. According to SAMHSA and the National Institute on Drug Abuse (NIDA), the primary intervention for individuals with substance use disorders is to get them engaged in formal substance use disorder therapy and other adjunctive forms of treatment, such as social support groups (e.g., 12-Step groups, community support groups, etc.), volunteer work, and complementary and alternative treatments, such as music therapy, animal assisted therapy, etc.

Medication-assisted therapy can be used in a number of ways to assist in the treatment of substance use disorders.

Medications do not directly address the issues that are involved in an individual’s substance use disorder; rather, they offer additional interventions to help in the treatment of certain physical and psychological symptoms associated with these disorders. Thus, despite many claims by medical associations that addiction is a disease that requires medical treatment, there actually is no formal medical treatment that can solely be used to address addictive behaviors. Instead, the primary treatment focus for all substance use disorders is counseling or psychotherapy.

These interventions can be enhanced by medical treatments; however, medical treatments cannot be used in place of these interventions.

 

Most of the time, the terms dual diagnosis and co-occurring disorders are used to refer to individuals who are diagnosed with a substance use disorder and some other comorbid mental health disorder. In some cases, individuals with co-occurring disorders may require medication for their psychological disorder, and in other cases, simple behavioral treatments for both co-occurring disorders may be sufficient.

Because individuals should be thoroughly assessed before they enter treatment, any potential comorbid conditions, both psychiatric and physical, should be identified before the treatment plan is drawn up. Individuals with a co-occurring psychiatric disorder will require this condition to be addressed along with their substance abuse. According to the American Society of Addiction Medicine (ASAM), failing to address the co-occurring psychiatric disorder in an individual with a dual diagnosis results in a situation where the client is almost certainly doomed to relapse.

The specific medication chosen will depend on the specific type of psychiatric disorder the individual has been diagnosed with, other personal factors as determined by the prescribing psychiatrist, and its compatibility with recovery from a substance use disorder. For instance, an individual with an alcohol use disorder who also suffers from an anxiety disorder could be at increased risk for relapse if they were prescribed benzodiazepines without sufficient monitoring and a plan of behavioral intervention to teach them to deal with their anxiety without long-term medication use. Typically, the use of benzodiazepines in the treatment of anxiety disorders was conceptualized as a short-term approach because these drugs are also highly addicting, and individuals who use them for a sufficient length of time are prone to developing physical dependence on them. Trying to get an individual to recover from an alcohol use disorder while maintaining them on benzodiazepines may not be a sound approach. Instead, other medications like BuSpar may be more appropriate for treating anxiety in individuals with alcohol use disorders.

On the other hand, individuals with psychotic disorders (e.g., schizophrenia) or bipolar disorder who are not as successfully treated by behavioral interventions like psychotherapy require long-term treatment with medications.

 

Individuals who have developed physical dependence on alcohol or some other substance will benefit from a physician-assisted withdrawal management program in the early stages of recovery. A physician-assisted withdrawal management program, also known as medical detox, is another form of medication-assisted therapy. Individuals undergoing the withdrawal process are monitored by an addiction medicine physician or psychiatrist, trained in addiction medicine, and they are administered specific types of medications (depending on their drug of abuse) to curb withdrawal symptoms, control cravings, and prohibit the development of potentially serious conditions, such as seizures.