What Is Medication-Assisted Treatment? How Taking Medication for Substance Use Disorders Can Help
Key takeaways:
Medication-assisted treatment (MAT) combines medications and therapy to treat substance use disorders. Examples include alcohol use disorder (AUD) and tobacco use disorder. When used for opioid use disorder (OUD), it’s called MOUD, or medication for opioid use disorder.
MAT and MOUD medications reduce cravings, withdrawal symptoms, and relapse and overdose risk. They are the best approaches for treating OUD, AUD, and tobacco use disorder.
The best MOUD or MAT medication for you depends on several factors. This includes whether you have other health conditions and how severe your substance use disorder is. It also depends on your preferences.
If you think you have a substance use disorder, contact a healthcare professional immediately. They can help you access medications and other treatment options. Alternatively, you can search for programs using the online treatment locator from the Substance Abuse and Mental Health Services Administration. Or call its National Helpline at 1-800-662-4357.
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Table of contents
Medications can be a useful tool in treating substance use disorders. In fact, medication-assisted treatment, called MAT, is recommended for treating alcohol use disorder (AUD) and tobacco use disorder. MAT combines therapy and medications to treat substance use disorders. This treatment method is also used to treat opioid use disorder (OUD). But it’s called MOUD, or medication for opioid use disorder.
Here, we’ll cover everything you need to know about MOUD and MAT.
What is MAT?
MAT combines medications and therapy to treat certain substance use disorders. The medications and type of therapy depend on the substance use disorder you’re treating, along with your preferences.
The medications used in MAT may help you reach your recovery goals, including:
Minimizing withdrawal symptoms
Minimizing cravings for substances
Increasing the likelihood of recovery from substance use disorder
Reduce the chances of relapse and overdose
MAT medications help you reach these goals by rebalancing brain chemicals after substance misuse. This makes alcohol and other substances less rewarding, which means you’re less likely to return to substance use.
Medications for MOUD: There are a few FDA-approved medications to treat opioid use disorder. They have several differences to consider when choosing the best option for you.
Medications for alcohol use disorder (AUD): Several medications help treat AUD. Some are FDA approved, and some are used off-label.
Understanding relapse: For many people, relapse is part of the journey to recovery. Understand what it is and how to help someone going through it.
What substance use disorders does MAT treat?
MAT and MOUD can treat the following substance use disorders:
MOUD refers only to medications for OUD. MAT refers to medications used to treat AUD and tobacco use disorder. The term MAT had been used to describe medications for OUD. But experts say MOUD makes it clear that medications are the core element of OUD treatment. This means that medications are beneficial even for people who don’t want therapy.
Not all substance use disorders have FDA-approved medications to treat them. For example, medications to treat sedative use disorder or stimulant use disorder are used off-label. The primary treatment for these conditions is often therapy.
What medications are used as part of MAT?
Below, we’ll cover the common medications used to treat OUD, AUD, and tobacco use disorder.
OUD medications
Medications that are FDA approved to treat OUD include:
Buprenorphine-only medications tablets and injections (Sublocade, Brixadi)
Buprenorphine / naloxone buccal tablets (Zubsolv) and sublingual film tablets (Suboxone)
Methadone liquid, tablets, and dissolvable powder and tablets (Methadose)
Each medication works in different ways. Buprenorphine medications and methadone are considered first-choice medications for treating OUD. But there are a few differences that may make one a better option than the other for you.
For example, methadone treatment is available only through registered opioid treatment programs. This requires daily visits to the clinic to receive your dose when you start treatment and for some time after. If you can’t visit a clinic daily, buprenorphine medications like Suboxone may be a better choice.
But there are different barriers to Suboxone use. Some prescribers recommend waiting at least 12 hours to take Suboxone after taking a short-acting opioid and at least 24 hours to take Suboxone after taking a long-acting opioid. This is because taking Suboxone too soon after opioid use can cause opioid withdrawal symptoms. But some prescribers may recommend starting Suboxone at a very low dose and increasing it over several days, rather than waiting to start.
Both buprenorphine-containing medications and methadone are taken daily. The naltrexone injection may be a good option for people who don’t want to take a daily oral medication. It’s only administered every 4 weeks.
AUD medications
The following medications are FDA approved to treat AUD:
Acamprosate tablets
Disulfiram tablets
Naltrexone tablets and injection
Each AUD medication works differently. They all share the goal of reducing or stopping alcohol use. Naltrexone and acamprosate are typically first-choice options over disulfiram. But when comparing naltrexone versus acamprosate, one may be a better option for you.
For example, both medications are available as tablets. But acamprosate is taken 3 times a day, while oral naltrexone is usually taken once a day. Additionally, naltrexone is available as a once-monthly injection called Vivitrol. You may prefer this to a daily oral medication. Keep in mind that Vivitrol has to be given by a healthcare professional. So you have to visit a medical office to receive it. And it’s available only as a brand-name medication.
Disulfiram is not typically a first-choice option, but it’s useful in some cases. It comes as an oral tablet that’s taken once daily. It works by causing a negative reaction if you drink alcohol after taking it. Symptoms of this reaction include vomiting, a racing heart, and flushing (pink or red skin). For some people, this mechanism of action is enough to keep them from drinking.
Other medications prescribed to manage AUD include topiramate (Topamax) and gabapentin (Neurontin). They’re not FDA approved for this condition, but thesemedications may be used off-label for AUD.
Tobacco use disorder medications
Several medications are FDA approved to help you quit smoking. They include:
Nicotine replacement therapy (NRT), such as patches (Nicoderm CQ, Habitrol), gum (Nicorette), and lozenges (Nicorette)
Bupropion sustained-release tablets (formerly known as Zyban)
Varenicline tablets (formerly known as Chantix)
Using these medications correctly and consistently increases your chances of quitting smoking. One reason for their effectiveness is that they reduce nicotine cravings and withdrawal symptoms. But varenicline or a combination of NRT products (the patches plus gum or lozenges) may be most effective.
What types of therapy can be used as part of MAT?
MAT combines medications and therapy to treat substance use disorder from all angles. Therapy can address your emotional and mental health differently from using medications. That’s why the two are often combined.
But medications are the mainstay of treatment for OUD, AUD, and tobacco use disorder. It’s often a good idea to combine medications and therapy. But therapy shouldn’t replace the use of medications.
Therapy can teach you coping skills and ways to live a fulfilling life in recovery. Some evidence-based therapies used as part of MAT and MOUD include:
Cognitive behavioral therapy (CBT). CBT emphasizes the connection between your thoughts, feelings, and behaviors. It can help you change negative thought patterns.
Contingency management (CM). CM focuses on changing behaviors through reinforcement. You receive prizes and rewards for completing actions related to recovery and wellness.
Motivational interviewing (MI). MI builds up your internal motivation and drive for recovery.
Other behavioral therapies and programs may also be good options. These include 12-step programs such as Alcoholics Anonymous and Narcotics Anonymous. When deciding what’s best for you, consider individual, group, or family therapy. A combination may work best. Joining a support group is also a treatment option worth considering.
How effective is MAT for substance use disorders?
MOUD and MAT are the most effective treatment options for substance use disorders. Using medications significantly decreases your risk of relapse. It also minimizes withdrawal symptoms and decreases the risk of opioid overdose.
But for MOUD and MAT to work, you have to stick with them. This means taking your medications exactly as prescribed. You also need to stay connected to your prescriber and support network. This may include support groups, therapists, and close friends and family.
What are the side effects and risks of MAT?
The benefits of treating MAT typically outweigh the risk of medication side effects. And if one medication isn’t a good option for you, there is likely another medication you can use. Still, all medications have possible side effects to consider.
For information on each medication’s side effects, check out other GoodRx Health articles linked below:
OUD medications | AUD medications | Tobacco use disorder medications |
Methadone tablets and oral solution Suboxone film Buprenorphine tablets Naltrexone tablets and injection | Naltrexone tablets and injection Acamprosate tablets Disulfiram tablets |
Is MAT just substituting one addiction for another?
Some MOUD medications (buprenorphine and methadone) are in fact opioids. But buprenorphine isn’t a “full” opioid, so it’s less likely to be misused or cause serious harms like overdose. Although methadone is a full opioid, it helps treat OUD effectively. In fact, it’s been used longer than other MOUD medications, so we have the most research on its effectiveness.
The idea that MAT or MOUD replaces one drug for another has had negative consequences. And simply isn’t true. It’s become a barrier to the widespread use of medications to treat substance use disorders. People using MOUD or MAT are closely monitored by healthcare professionals. These medications help you live without dependence on substance use. This gives you more time and energy to invest in healthy relationships, work, and school.
How can you access MAT?
If you think you have a substance use disorder, tell a healthcare professional immediately. A few signs to look for include:
Spending considerable time getting substances, using them, and then recovering from use
Experiencing relationship problems due to use
Needing more of the substance over time
Feeling odd or uncomfortable without the drug
Struggling to quit taking the substance, even if you want to
Continuing to use a substance even though it could harm you
A primary care provider can prescribe most MAT or MOUD medications. Still, you may benefit from working with an addiction medicine specialist.
When determining if MAT or MOUD is a good option for you, a healthcare professional will consider several factors. These include your history with substance use, other health conditions, and other medications. They’ll also consider how motivated you are to quit.
There are many options for care, including inpatient and outpatient services. You can also use the online treatment locator from the Substance Abuse and Mental Health Services Administration to search for programs near you. Or you can callits National Helpline at 1-800-662-4357 to learn about resources in your area.
Frequently asked questions about MAT
The best medication for OUD depends on your situation. Factors to consider include other medications you take, how severe your OUD is, and other health conditions.
In general, buprenorphine-containing medications like Suboxone, or methadone, are first-choice options for OUD. But one may be better for you.
If you’re starting naltrexone or buprenorphine, a prescriber may recommend waiting after your last dose of opioids. Starting these medications too soon can increase your risk of opioid withdrawal symptoms. But this may not always be the case. So ask your prescriber about their process for initiating naltrexone or buprenorphine.
With methadone, no waiting period is necessary.
Some people may need MAT or MOUD for many years or even indefinitely. But it depends on your situation and preferences.
If you’re taking MAT or MOUD medications and you want to stop them, talk to your prescriber first. Stopping medications for substance use disorders can be risky. It may increase the likelihood of relapse and overdose. Your prescriber will know if you’re ready to safely stop these medications. They can help you come up with a plan to reduce your dose slowly if necessary.
The bottom line
Medication-assisted treatment (MAT) and medication for opioid use disorder (MOUD) are comprehensive approaches to treating substance use disorders. MAT and MOUD combine medications and therapy to increase your chances of recovery. These treatments are the best approach for treating opioid use disorder, alcohol use disorder (AUD), and tobacco use disorder.
MOUD and MAT help reduce cravings for substances, withdrawal symptoms, and the risk of relapse and overdose. MOUD includes Suboxone (buprenorphine / naloxone), methadone (Methadose), and naltrexone (Vivitrol). AUD medications include acamprosate, disulfiram, and naltrexone. Tobacco use disorder medications include nicotine replacement therapies, bupropion sustained release, and varenicline. These medications have possible side effects, but the benefits typically outweigh the risks.
Why trust our experts?
References
Miller, J. C., et al. (2023). A guide to expanding the use of buprenorphine beyond standard initiations for opioid use disorder. Drugs in R&D.
National Association of Counties Opioid Solutions Center. (n.d.). Medication-assisted treatment (“MAT”) for opioid use disorder.
Spayde-Baker, A., et al. (2023). A comparison of medication-assisted treatment options for opioid addiction: A review of the literature. Journal of Addictions Nursing.
Substance Abuse and Mental Health Services Administration. (2024). Find substance use disorder treatment.
Substance Abuse and Mental Health Services Administration. (2024). Medications for Substance Use Disorders.
If you or someone you know struggles with substance use, help is available. Call SAMHSA’s National Helpline at 1-800-662-4357 to learn about resources in your area.
