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Medication assisted treatment MATMedication assisted treatment (MAT) for opioid addiction has been endorsed by the American Medical Association, the American Academy of Addiction Psychiatry, and the American Society of Addiction Medicine. However, MAT is often misunderstood by those in search of effective recovery options.

What Medications Are Used to Treat Opioid Addiction?

The most common medications used to treat opioid addiction are:

  • Methadone
  • Buprenorphine (sold under the brand names Suboxone and Subutex)
  • Extended release naltrexone (sold under the brand name Vivitrol)

Both buprenorphine and methadone are classified as essential medicines by the World Health Organization. Methadone is given as an oral tablet, liquid, or wafer from licensed opioid treatment clinics only. Patients must visit the facility daily to receive treatment. Buprenorphine can be given as a tablet, a film placed under the tongue or against the inside cheek, or an implant inserted in the arm. Only specially credentialed doctors can prescribe buprenorphine.

Are There Any Side Effects?

Constipation and sweating are the most frequently reported side effects of treatment, followed by nausea, back pain, chills, weight gain, insomnia, and decreased libido. Side effects may decrease in severity as your body adjusts to the medication, but you should discuss any concerns about side effects with your healthcare provider.

The medications used to treat opioid addiction could interact with some prescription medications, such as SSRI antidepressants and those used to treat HIV. You will need to tell your healthcare provider about all of the medications you are currently taking to determine if medication assisted treatment is right for you.

Patients who suffer from liver disease require close monitoring white undergoing MAT.

Is MAT Safe for Pregnant Women?

MAT is considered safe for pregnant women, with much less risk to the unborn baby than continuing to abuse heroin or other opioids during pregnancy. Both methadone and buprenorphine will show up in a drug screen after a woman gives birth, but no action will be taken if your healthcare provider verifies that the medications are being used as part of your substance abuse treatment plan.

Since buprenorphine is a newer medication and has been the subject of less research, methadone is considered the standard choice for pregnant women. Buprenorphine is considered a Pregnancy Category C medication, which means the risk of adverse effects has not been ruled out.

After giving birth, women on low doses of methadone may be able to breastfeed. If you wish to breastfeed, this should be discussed with your healthcare provider.

How Long Does Medication Assisted Treatment Last?

The duration of MAT for opioid addiction is decided on a case-by-case basis. In most cases, the goal is to taper off the dosage slowly as you become more comfortable and confident in your sobriety. However, patients with a history of relapse can safely take their medication on a long-term basis if they are properly monitored.

There are three phases of MAT:

  • Induction: A medically monitored beginning of MAT, which occurs when the patient is in the early stages of withdrawal.
  • Stabilization: An adjustment of the dosage until the patient is reporting no cravings and experiencing few, if any, side effects.
  • Maintenance: When the patient is doing well with a steady dose of medication, options for ongoing recovery are discussed. This can include either tapering off the medication altogether or continuing indefinitely to prevent relapse.

Isn’t MAT Simply Substituting One Addiction for Another?

People who’ve struggled with opioid addiction are often leery of medication assisted treatment because they believe that it’s best to get sober without any pills in their system. However, the medications used for treating opioid addiction do not result in getting high. The dosage is intended only to reduce cravings and withdrawal symptoms by balancing the brain circuits affected by addiction. This gives your brain time to heal as you work towards recovery.

Medication assisted treatment does not interfere with cognitive functioning. This means you can work, attend school, care for your children, and enjoy relationships with friends and family while receiving treatment.

Can Medications Cure Opioid Addiction?

Treatment for opioid addiction should combine medications with counseling to address the underlying issues contributing to substance abuse. Medications on their own are not a sufficient treatment for addiction, but using medication assisted treatment has been proven to improve retention rates in counseling programs.

Addiction is a chronic illness, so someone who suffers from opioid addiction will never be fully cured in the traditional sense. However, treatment can help an addict learn to manage cravings to live a full and productive life.

By Dana Hinders

Principles of effective addiction treatment

Every addiction treatment program aims to help clients stop using drugs or alcohol, stay sober, and become productive members of society. However, this doesn’t mean that all treatment programs are the same. If you’re considering addiction treatment for yourself or someone you love, it’s important to be aware of the basic principles that an effective treatment plan should be based on.

Addiction Is a Disease
Addiction isn’t a moral failing. It’s a disease that affects both brain function and behavior, with many studies indicating that addiction can be linked to specific genes and inherited personality traits.

Effective addiction treatment should stress empathy and compassion. Just as you wouldn’t chastise a patient for being diagnosed with cancer, people with drug and alcohol addiction don’t need to be judged for their past mistakes. They need treatment that heals their mind, body, and spirit.

Treatment Doesn’t Need to Be Voluntary to Be Effective
Ideally, someone suffering from addiction would realize the need to seek treatment and make positive life changes. However, treatment can still be beneficial even if an addict is in denial about the severity of his addiction.

Involuntary treatment can be court ordered or it can be arranged by a concerned family member, such as a spouse or parent. For young people in particular, early intervention can prevent an addiction from destroying a promising future.

Treatment Requires a Personalized Approach
When it comes to treating drug or alcohol addiction, there is no single treatment that’s right for everyone. Some people respond well to talk therapy individually or in a group, while others prefer to explore the issues surrounding their addiction in art therapy, music therapy, or other experiential therapies. There may also be special concerns, such as anxiety, depression, or an eating disorder, that need to be addressed in addition to drug or alcohol addiction.

Part of the personalized approach to addiction treatment requires that care plans be periodically reevaluated to ensure their effectiveness. For example, a counselor might determine that a client who is experiencing difficulty transitioning back to work may have moved through the steps of their plan too quickly and would benefit from additional time to develop positive coping skills for handling stressful situations.

Detox Is Just the First Step
Addiction treatment typically begins with a detox to help clients remove drugs and alcohol from their system. During this time, clients are monitored and given medication to help minimize painful or potentially dangerous withdrawal systems.

While detox is a necessary part of the treatment process, the initial experience of getting clean is just the beginning. Multiple studies have shown that people who receive no treatment following detoxification typically resume their drug or alcohol use a short time later.

Behavioral Therapy is Key
Behavioral therapy is a cornerstone of any effective addiction treatment program. Behavioral therapy aims to help substance abusers modify their attitude towards drug or alcohol use, increase healthy life skills, and provide the motivation necessary to persist with a long-term treatment plan.

In the early stages of residential treatment, clients may be scheduled for daily sessions. However, as they graduate to outpatient treatment, sessions will gradually become less frequent and focused on building an independent recovery.

Medication Can Help
Medication can be very effective when combined with behavioral therapies. Medications can be used during the detox process or to help prevent relapse, as long as their use is carefully monitored by trained professionals. For example, Methadone (Dolophine, Methadose), naltrexone (Vivitrol), and buprenorphine (Suboxone, Subutex, Probuphine) can be used to treat opioid addiction.

When substance abuse is linked to a desire to self-medicate a mental health disorder, medication can be used to get these underlying conditions under control. For example, antidepressants can stabilize the mood swings associated with depression and thus help reduce cravings for drugs and alcohol.

There’s No Quick Fix
Treating addiction takes time. Nobody develops an addiction overnight, so it’s unreasonable to expect that a treatment center will be able to work miracles in a few days. An addiction treatment program typically lasts at least 30 days, with extensive follow up care afterwards.


A person who struggles with drug and alcohol addiction won’t be “cured” when they leave a treatment facility. Addiction is a chronic illness that requires vigilance to prevent relapse, much like diabetics must pay careful attention to their blood sugar each day. Someone in recovery will still experience cravings and be faced with the temptation to use, but the skills they learned in treatment will allow them to make positive choices and set the stage for a brighter future.

By Dana Hinders

Taking Time Off Work to Attend Rehab

One of the most common fears people struggling with drug and alcohol addiction have is how to seek treatment without putting their job at risk. While this issue does need to be handled carefully, evidence suggests that seeking treatment is much more likely to provide a boost to your career as opposed to simply ignoring your substance abuse problem. When you’re sober, you’re free to focus your attention on achieving your career goals instead of dealing with the effects of your addiction.

Sharing Sensitive Information with Your Employer and Coworkers
How you choose to handle explaining the reason behind your absence is entirely up to you. Some people decide to be totally forthcoming about their need to seek treatment, while others keep the information strictly on a need-to-know basis.

If you work in a close-knit environment, your supervisor and coworkers may already suspect that you need help based on their observations. If so, they’re likely to be supportive of the efforts you’re making in taking control of your addiction. Even though it can be scary to admit vulnerability, being upfront about your need to seek treatment can be seen as a sign of your integrity and honesty, as well as your commitment to your employer. As an added benefit, your supervisor may be able to connect you to additional resources through the company’s Employee Assistance Program.

Seeking addiction treatment is nothing to be ashamed of, but keeping your decision confidential might be in your best interests if you don’t feel your colleagues will be supportive. If you’re worried about protecting your privacy, you can work with the human resources department directly to minimize the number of people who know the reason for your absence. A doctor’s note explaining the reason for your absence may be required, but your doctor is ethically bound to protect your privacy. All he or she needs to do is certify that your need for time off work is due to a legitimate medical condition. Others who don’t need to know this confidential information can simply be told you’re taking a leave of absence to attend to some personal matters or that you’re using accrued vacation time.

Legal Protections for People Seeking Addiction Treatment
While absence from work due to substance use doesn’t qualify for legal protection, seeking addiction treatment is protected under the Family and Medical Leave Act of 1993 (FMLA). Taking leave under FMLA allows you to request an unpaid leave of absence of up to 12 weeks in a 12-month period. Employers are not allowed to terminate a worker simply because he or she has requested FMLA leave for a qualifying condition.

There are specific requirements you must meet to take advantage of FMLA. You must have worked for your employer for at least 12 months, have worked for a minimum of 1,250 hours over the past 12 months, and be employed at a location with at least 50 workers employed by the company within 75 miles.

If your employer violates the FMLA, you can seek legal action. A settlement may include compensation for lost wages, loss of future earning potential, and any applicable liquidated damages.

Alcohol and drug addiction are also considered disabilities under the Americans with Disabilities Act (ADA). Current substance abuse isn’t protected, but employers must provide reasonable accommodations if you’re sober and in a recognized treatment program. This often includes flexible scheduling, with options such as leaving early, working from home, being allowed to refuse overtime to attend counselling or support group meetings, and taking an unpaid leave of absence.

If your employer violates the ADA, you can file a federal suit. You won’t receive monetary damages, but your employer can be ordered to make the necessary accommodations to be in compliance.

Concerns Related to Performance Issues
If your employer has a drug and alcohol use policy in place that was clearly communicated to all employees and is consistently enforced, you can be terminated if there is proof you violated the policy. Your employer can also terminate your position for performance issues related to your drug and alcohol use. This might include:

  • Being late to work
  • Missing too much work
  • Inappropriate behavior towards coworkers or clients
  • Ignoring safety precautions or causing accidents
  • Mishandling sensitive information
  • Theft or misuse of company resources

If there is concrete proof of performance issues, it legally doesn’t matter what the cause of the issue is. For this reason, it’s in your best interests to seek addiction treatment before your drug or alcohol misuse starts affecting your job performance.

By Dana Hinders

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