Medication-Assisted Treatment (MAT) in Ohio

Beginning the addiction recovery process can be incredibly difficult when you’re struggling with intense cravings and other withdrawal symptoms. Fortunately, rehab centers like The Recovery Village Columbus offer medication-assisted treatment that can help you stop using substances like opioids or alcohol and learn how to remain sober.

What Is Medication-Assisted Treatment (MAT)?

Medication-assisted treatment (MAT) is an evidence-based treatment for both opioid and alcohol addiction. When a person participates in MAT, they take medications that block cravings or act as a substitute for opioids or alcohol. 

MAT is important in helping to prevent relapse, which is common in recovery. As part of a comprehensive rehab care plan, MAT can help fight cravings that might otherwise trigger a relapse, helping you maintain your long-term recovery from opioids or alcohol.

Medication-Assisted Treatment for Alcohol Abuse

Quitting drinking can be very taxing on your body. This is because alcohol impacts many facets of your brain and body’s chemical balance. When you drink, the brain releases dopamine, a feel-good chemical in the brain’s reward pathway. Alcohol also causes your brain to release the relaxing chemical gamma-aminobutyric acid (GABA), which slows down the brain’s activity and causes sedation.

When you drink excessively for a long time, your brain adapts to the extra dopamine and GABA. This means that when you suddenly stop drinking, you can get alcohol withdrawal symptoms. MAT for alcohol abuse helps you stay sober by easing your body’s response to the absence of alcohol. To prevent side effects, the medications are started after detox is complete and your system is free of alcohol.

Alcohol Abuse Treatment Medications

The Food and Drug Administration has approved three drugs for treating chemical imbalances that result from chronic heavy alcohol abuse. These drugs are naltrexone, disulfiram and acamprosate, and they work by reducing withdrawal symptoms or reducing dopamine’s feel-good effects. 

Naltrexone

Naltrexone (ReVia, Vivitrol) is an opioid-receptor antagonist that is often prescribed to people in recovery from alcohol abuse. The drug is available as a daily oral tablet and as a long-acting monthly injectable. Naltrexone is most effective in those who have stopped drinking and need assistance staying sober.

The drug works by reducing the pleasurable effects of drinking. When you take naltrexone, your brain doesn’t release as much of the feel-good chemical dopamine when you have a drink. 

Disulfiram

Disulfiram (Antabuse) is a daily oral tablet for those who no longer drink but want extra help staying sober. It can also benefit those who want extra motivation to avoid drinking, as the drug makes you feel sick if you drink.

Disulfiram impedes alcohol’s breakdown in your body. Under normal circumstances, your body converts first alcohol into acetaldehyde and then into acetic acid, or vinegar. Disulfiram interferes with the steps in the breakdown process. Specifically, the drug blocks an enzyme called acetaldehyde dehydrogenase, which converts acetaldehyde into acetic acid. 

If you drink while taking disulfiram, the buildup of acetaldehyde can make you feel sick. It causes unpleasant symptoms that include bad headaches, vomiting and weakness.

Acamprosate

Acamprosate (Campral) is a medication that comes as an oral tablet you take three times a day. The drug helps you stay sober by lesseningalcohol withdrawal symptoms. It accomplishes this by reducing the amount of a chemical called glutamate in the brain. 

Glutamate can cause problems during alcohol withdrawal. If you drink heavily and suddenly stop, the amount of glutamate in your brain often increases, leading to withdrawal symptoms. Since acamprosate lessens glutamate in the brain, the drug helps you avoid withdrawal symptoms. 

Medication-Assisted Treatment for Opioid Addiction

Opioids achieve their pain-relieving effects through their actions on the brain’s mu opioid receptors. These drugs are addictive because they trigger the brain’s reward pathway that increases feel-good chemicals like dopamine. With chronic use, the body adjusts to the presence of opioids and becomes dependent on them. For this reason, suddenly stopping or cutting back on opioids can cause withdrawal symptoms. 

MAT for opioid use disorder is prescribed to help ease opioid withdrawal symptoms and prevent relapse. MAT therapies for opioid use disorder can usually be started as soon as a person begins the detox process.

Opioid Addiction Treatment Medications

Experts strongly recommend MAT as a cornerstone of opioid use disorder treatment. Three primary medications are often prescribed as MAT for opioid abuse: methadone, buprenorphine and naltrexone.

Methadone

Experts consider methadone (Dolophine, Methadose) to be a first-line treatment for opioid use disorder. When prescribed for MAT, the drug usually comes as an oral liquid taken once daily.

The drug is a long-acting opioid that works similarly to other opioids on the brain’s mu opioid receptors. However, as an extremely long-acting drug with a slow onset, methadone does not cause the euphoric high generally associated with opioids. Instead, methadone works by preventing both withdrawal symptoms and cravings. Further, the drug stops a person from getting high if they slip up and take another opioid.

Methadone is offered through specialized clinics and is not provided at The Recovery Village Columbus. However, alternative medications are available.

Buprenorphine

Like methadone, buprenorphine (Belbuca, Buprenex, Butrans, Probuphine, Sublocade) is an opioid that is widely considered to be a first-line treatment for opioid use disorder. It works similarly to methadone in that it prevents withdrawal symptoms and cravings, and it blocks a high if a person relapses. Buprenorphine comes in several oral forms taken once daily, including orally disintegrating tablets and strips. The drug is also available as a long-acting injectable or implant (Probuphine, Sublocade).

Buprenorphine is sometimes prescribed on its own, but it is more commonly prescribed as a combination drug that contains the opioid reversal agent naloxone (Bunavail, Suboxone, Subutex, Zubsolv). The naloxone component of the drug combination plays an important role, as it ensures that the drug is not misused. Naloxone is inactive when a person takes buprenorphine as directed by mouth. However, if someone attempts to misuse buprenorphine by dissolving and injecting it, the naloxone becomes active and blocks buprenorphine’s effects.

Naltrexone

Naltrexone (ReVia, Vivitrol) is not considered a first-line therapy, unlike methadone or buprenorphine. Naltrexone is an opioid blocker that stops opioids from attaching to the brain’s mu-opioid receptors. It is available both as an oral tablet taken daily and as a long-acting injection.

Because it blocks opioids, naltrexone can trigger withdrawal if you happen to have opioids in your system when you start the drug. For this reason, naltrexone should only be started when your body is completely opioid-free, which may be as long as 14 days after the last opioid dose. 

Benefits of Medication-Assisted Treatment

Medication-assisted treatment is an important tool in helping people stay sober after deciding to quit alcohol or opioids. In the case of opioid use disorder, MAT can start to work quickly to ease withdrawal symptoms and prevent relapse. Similarly, in the case of alcohol use disorder, MAT can keep a patient from relapsing and help them maintain sobriety.

Is Medication-Assisted Treatment Effective?

MAT is extremely effective for both opioid and alcohol abuse and is recommended by experts for this reason. In those who struggle with drinking, research shows that MAT helps to prevent both relapse and death from drinking. In those who suffer from opioid use disorders, MAT helps prevent relapse. 

About Medication-Assisted Treatment at The Recovery Village Columbus

Medication-assisted treatment is a cornerstone of recovery care for opioid and alcohol abuse. Used alongside interventions like detox and rehab, MAT can help prevent withdrawal symptoms and relapse. Long-term behavioral change in recovery takes time and can involve slip-ups, but MAT can significantly lessen the risk of these slip-ups and make them less dangerous.

In opioid use disorder, MAT is started early in the detox process to help prevent withdrawal symptoms as they occur. MAT can then be continued throughout rehab. Experts even recommend staying on MAT indefinitely in many cases to help support a person’s long-term sobriety. 

In alcohol use disorder, MAT begins later in the recovery process. It is not started during detox, as this can cause withdrawal symptoms. Instead, MAT for alcohol comes later, helping support people after rehab as they begin to navigate the world and try to remain alcohol-free. MAT for alcohol use disorder can be continued as long as the person desires.

At The Recovery Village Columbus, we are here to support you at every step of the treatment process. Throughout detox, rehab treatment and aftercare, we offer MAT as medically appropriate to help clients navigate their recovery journey. Contact us today to learn more about MAT and other treatment programs that can work well for your needs.

Editor – Jonathan Strum

Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more

Medically Reviewed By – Dr. Jessica Pyhtila, PharmD

Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more