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Miami Medication-Assisted Treatment

Medication-assisted treatment (MAT) combines the use of medications, counseling, and other supportive services to treat people who have substance use disorders. 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 use disorders.

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 Medication-Assisted Treatment Help With Opioid Addiction? "

MAT helps to reduce withdrawal symptoms, address cravings, and provide medical supervision. It helps people manage their addiction so that the benefits of recovery can be maintained.

People who have been abusing opioid drugs and abruptly stop experience withdrawal symptoms. The symptoms are so unpleasant that many people start taking the drugs again in order to avoid these symptoms. People in the midst of an opioid withdrawal will also experience extreme cravings to take their drug of choice.

MAT works to:

  • 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 recovery.
  • Facilitate a slow, controlled taper of the drug so that the person can adjust to living without opioids.
  • Provide medical supervision during 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 relapse.

How Long Does Medication Assisted Treatment Last ?

MAT often addresses the acute withdrawal process. In some cases, MAT can be indefinite if the person has serious issues with relapse; the person’s treatment is evaluated closely by a physician trained and qualified to do so.

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 or maintenance is based on the person's particular circumstances, the physician's judgment, and the input of the treatment team.

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Medications Used in Our Miami Treatment Center

Buprenorphine

Buprenorphine (Buprenex, Butrans, Subutex) 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 gradually tapered.

Naltrexone

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

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.

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Medication Assisted Treatment Procedure

A physician who specializes in addiction treatment (including psychiatrists) at Holistic Recovery Centers must evaluate the person that is considering MAT. It is required that the physician supervise MAT and the medications require a prescription.
The typical MAT treatment process is outlined below.

  1. Physician Evaluation. The process begins with an evaluation conducted by a physician who is qualified to administer MAT or by otherwise consulting with a therapist or addiction treatment team to coordinate an evaluation with our physician.
  2. Determining suitability. The physician evaluates the person and determines his or her suitability for MAT. During this process, the person will receive a complete physical and education about the MAT procedure.
  3. Prescribing medication. If the physician determines that the person is a good fit for MAT, he or she will prescribe the appropriate medication once the person begins to experience mild withdrawal symptoms. The person should avoid any opioid medications during this stage.
  4. Stabilization/maintenance of medication. The treatment process typically includes 3 to 4 phases:

Induction phase to establish the dose of the medication.

A stabilization phase where the minimal dose required to avoid withdrawal symptoms is established, the person continues to use the medication (which can be adjusted depending on symptoms) and the person refrains from opioid use.

A maintenance or withdrawal phase from the medication, which can take place in 2 separate phases or 1 complete phase.

  • 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 or medical
  • 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. 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.
Due to relapse being 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.

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Behavioral Therapy

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 additional services in the community, if needed.

Therapies that may be helpful for people in MAT include:

  • Cognitive behavioral therapy
  • Contingency management
  • Motivational interviewing
  • Family Therapy

Benefits of Medication-Assisted Treatment

  • Medication-assisted treatment offers several benefits to a person who wants to quit using opioids.
  • 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.

MAT, particularly with opioid agonist medications, has been shown to:

  • Reduce morbidity and mortality.
  • Reduce deaths from overdose.
  • Reduce infectious disease transmissions.
  • Reduce criminal activity.
  • Help keep people in treatment.
  • Improve social functioning.

Precautions About Using Medication for Opioid Addiction

  • While MAT has several advantages, it also has some potential drawbacks.
  • The medications used in MAT can produce unpleasant side effects.
  • Some of the medications used in MAT are potentially addictive themselves. Eventually, the user will have to taper down the dosage of these to become totally drug-free.
  • If a person in MAT relapses, his or her tolerance level to the original drug of abuse is often lowered. If the person uses the original drug, his or her risk of overdose is increased.
  • MAT is not a stand-alone treatment approach. In order to ensure recovery, the person must address the root causes of the substance use disorder. This can only be accomplished by engaging in a -comprehensive substance use disorder recovery program that includes counseling/therapy , social support and long-term aftercare treatment planning.

Other Types of Medication-Assisted Treatment

  • Medication-assisted treatment 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.
  • Naltrexone is also used to treat alcohol use disorders.
  • Wellbutrin, an antidepressant, has been used to treat nicotine addiction.
  • 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 disorders.

If you do not have insurance and are concerned about the cost of entering a formal rehabilitation program, contact the Substance Abuse and Mental Health Services Administration’s (SAMHSA) national helpline.

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