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Why is ongoing Medication for Addiction Treatment (MAT) more beneficial than detox alone?

Medication for Addiction Treatment (MAT) promotes long-term sobriety, helping people to live healthy, balanced lives in recovery. It is a comprehensive treatment approach that also addresses psychological needs and overall well-being. 

If a person with opioid use disorder (OUD) only goes through detox, it is likely that they will relapse and return to opioid use. MAT can help prevent relapse. 

How Is MAT Different Than Detox?

While it’s possible to withdraw from opioids without medication assistance, it increases the risk of relapse due to the discomfort involved. MAT, in combination with psychosocial resources, is the standard of care for treating opioid use disorder, both immediately during detox and for ongoing maintenance.[1]  

MAT during detox and into ongoing recovery has been shown to do the following:[1]

  • Reduce chances of opioid overdose
  • Increase engagement in treatment
  • Improve patients’ ability to secure and maintain employment
  • Decrease criminal activity associated with opioid use
  • Improve overall quality of life

MAT isn’t just the use of medications. It also involves counseling and behavioral treatments in a whole-person approach to care.

Conversely, detox just involves allowing drugs to process out of the body. Medical detox involves supporting the patient with medications and other forms of medical assistance during the detox phase, but that support is limited and short-term. 

With MAT, you have that medical support on an ongoing basis after the acute treatment phase is complete.

Which Medications Are Used in Detox

Methadone and Buprenorphine are the two main medications used in MAT for opioid use disorder. Vivitrol is another second line option. This is an opioid antagonist that can be used for people who cannot or do not want to take methadone or Suboxone.

“Adjunctive medications” can also be used during opioid detox and ongoing recovery if deemed appropriate. These are not opioids, but they help treat some of the side effects of opioid withdrawal. 

Clonidine may be prescribed to address tremors and anxiety. Loperamide may be recommended for diarrhea. Dicyclomine may be prescribed for abdominal pain or cramping. These medications can address symptoms on an individual basis, but they don’t work consistently as well as MAT, which is why they are considered second line or “adjunctive” medications.

MAT Works Better for Every Stage of Recover

In the early stage of recovery, MAT allows patients to focus on therapy instead of uncomfortable withdrawal symptoms. Without MAT, patients cannot focus on anything else other than their discomfort, and it’s likely they will return to opioid use to make that discomfort disappear.

With Suboxone or any MAT, opioid withdrawal symptoms are lessened significantly, even eliminated entirely, so patients can prevent relapse. 

Suboxone doesn’t have to be just  a short-term treatment. Many people safely remain on Suboxone or other MAT for months or years. Some people remain on it indefinitely as it continues to support recovery and prevent relapse. Addiction is a chronic, lifelong disease, so medications can likewise be provided lifelong to prevent relapse .[2]

Ultimately, MAT is an effective option to treat opioid dependence, reduce cravings, and improve quality of life for people with OUD.[3]

It works better than detox alone due to the whole-patient approach involved. Detox doesn’t address underlying issues with counseling and therapy. MAT does. 

 SOURCES

  1. Medication-Assisted Treatment (MAT). Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medication-assisted-treatment. March 2022. Accessed April 2022.
  2. 5 Myths About Using Suboxone to Treat Opiate Addiction. Harvard Health Publishing. https://www.health.harvard.edu/blog/5-myths-about-using-suboxone-to-treat-opiate-addiction-2018032014496. October 2021. Accessed April 2022.
  3. Buprenorphine. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK459126/. August 2021. Accessed April 2022.

Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.

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