Medication Assisted Treatment (MAT)
Historically, Substance use disorders, previously called chemical dependency, has been treated primarily with individual and group talk therapy after medical detoxification, if needed. In more recent years new medical techniques called Medication Assisted Treatment, or MAT, have developed. These techniques include the use of the following medications:
For alcohol use problems
- Naltrexone - reduces the euphoria, the “high” from alcohol, and may reduce cravings for alcohol. It also comes in a long acting shot, Vivitrol.
- Disulfiram - also known as Antabuse, this medication blocks our body’s ability to break down alcohol, leaving toxic acetaldehyde levels. Acetaldehyde causes skin flushing, sweating, headache, chest pains, heart palpitations, and nausea. The symptoms are severe and deter most people from using alcohol.
- Acamprosate – reduces cravings for alcohol in some people
For opioid (i.e. heroin, oxycodone) use problems
- Methadone – a very long acting opioid, methadone can be dosed once daily to provide relief from opioid cravings while limiting the high and allowing more stable behavior and function. This is the original “harm reduction” treatment that has helped many to stop using. Overdose is a major risk.
- Buprenorphine - (with or without naloxone), most well known as Suboxone form, is another long acting opioid type drug that is safer from overdose and leads to more normal behavior and function. Naloxone, a short acting opioid blocker, is added to help reduce abuse in some formulations.
- Naltrexone – is a longer acting opioid blocker that prevents that action of heroin and other opioid like an antidote to poison. It also comes in a long acting shot Vivitrol that needs to be given every 28 days to be effective.
Nicotine use problems (cigarettes, chew/snuff, vaping, etc..)
- Nicotine replacement – skin patches, gum, lozenges, inhalers replace nicotine in various strategies to reduce harm and help taper off nicotine
- Bupropion – (Wellbutrin) an antidepressant that is typically well tolerated and found to reduce cravings for nicotine
- Varencicline – (Chantix) is a nicotine blocker that renders cigarettes ineffective. Used properly it can be a very effective means of stopping nicotine use.