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How substance use counselors can address various issues in medicated-assisted treatment (MAT)

Addressing Challenges in Medication-Assisted Treatment (MAT): Key Issues and Strategies for Substance Use Counselors

Medicated Assisted Treatment (MAT) presents a holistic approach to treating substance use disorders, combining medication, counseling, and behavioral therapies.

However, individuals undergoing MAT encounter numerous barriers that can impede their recovery journey. Various common challenges in medicated-assisted treatment continually reoccur nationwide. 

This article aims to empower substance use counselors with the necessary knowledge and skills to address these challenges and provide comprehensive support to their clients.

In this blog post we wil discuss, we will explore essential areas such as relapse prevention, mental health challenges, social barriers, and the nuances of Benzodiazepine use in MAT.

Our objective is to equip substance use counselors to navigate the multifaceted nature of recovery in MAT programs and learn how to address challenges in medicated assisted treatment effectively.

Addressing Challenges in Medication-Assisted Treatment (MAT):


1. Confronting Self/Internal Stigma

Internalized stigma about being in an MAT program can significantly hamper a client’s recovery journey, leading to feelings of shame, guilt, and low self-esteem.

As a substance use counselor, your role involves helping clients confront and overcome this internal stigma.

To effectively address this challenge in medicated-assisted treatment, here are some Action Steps to take:

  1. Normalize the Recovery Process: Reinforce that seeking help for substance use disorders is a sign of strength, not weakness. Encourage open conversations about their experiences and feelings associated with MAT.
  2. Empower Clients: Help clients understand they are more than their substance use disorder. Encourage them to focus on their strengths, accomplishments, and potential.
  3. Promote Self-Compassion: Encourage clients to practice self-compassion. Self-compassion involves mindfulness exercises, therapeutic writing, or simply learning to replace self-critical thoughts with more compassionate ones.


2. Understanding ‘Return to Use’

‘Return to use’ or relapse is often seen as a failure, but it’s crucial to view it as part of the recovery journey. As a substance use counselor, you can effectively help clients manage ‘return to use.’

To effectively address this challenge in medicated-assisted treatment, here are some Action Steps to take:

  1. Early Warning Sign Identification: Equip clients with the skills to identify early warning signs of a relapse, such as changes in mood, attitude, or behavior.
  2. Developing a Relapse Prevention Plan: Work with clients to create a personalized relapse prevention plan. Relapse prevention or recurrence of symptoms includes strategies to manage triggers, stress management techniques, and a support network they can contact.
  3. Reframing Relapse: Help clients understand that relapse doesn’t mean failure. Instead, it’s an opportunity to learn and adjust their recovery plan.


3. Addressing Mental Health Challenges in MAT

Co-occurring mental health disorders can complicate the treatment of substance use disorders. Substance use counselors need to be competent in identifying symptoms of mental health issues and making appropriate referrals.


To effectively address this challenge in medicated-assisted treatment, here are some Action Steps to take:

  1. Screening and Assessment: Regularly screen clients for signs of mental health disorders. Conduct a comprehensive assessment to understand the client’s needs better if symptoms are identified.
  2. Referral to Mental Health Services: When identifying a mental health disorder, refer the client to appropriate mental health services. Close collaboration with mental health professionals can ensure the client receives comprehensive care.
  3. Integrated Treatment Approach: Use an integrated approach to treat both substance use and mental health disorders. Integrated care involves combining medication, psychotherapy, and support services.

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4. Addressing Social Barriers

Societal stigma, employment difficulties, and complex family dynamics can pose significant barriers to recovery. Substance use counselors can play a crucial role in helping clients overcome these challenges.


To effectively address this challenge in medicated-assisted treatment, here are some Action Steps to take:

  1. Advocacy: Advocate for your client’s needs within the community. Community advocacy involves working with local employers, schools, and other community resources.
  2. Family Education and Support: Provide education and support to clients’ families. Family education helps them to understand the nature of substance use disorders and the recovery process, enabling them to provide better support.
  3. Employment and Housing Assistance: Help clients find stable employment and housing. The structure can significantly improve their quality of life and support their recovery journey.


5. Benzodiazepine Use in MAT

Benzodiazepines can play a role in MAT, especially for clients with co-occurring anxiety disorders. However, building trust and rapport with the client allows you to safely monitor Benzo’s use due to the risk of dependency and overdose.


To effectively address this challenge in medicated-assisted treatment, here are some Action Steps to take:

  1. Education: Educate clients about the risks and benefits of Benzodiazepines. Ensure they understand the importance of using these medications only as prescribed.
  2. Monitoring: Regularly monitor clients who are prescribed Benzodiazepines. Monitoring can help identify issues early and adjust the treatment plan as necessary.
  3. Safe Use Practices: Promote safe use practices, such as not sharing medication, avoiding alcohol while on these medications, and safely storing and disposing unused medication.


6. Comprehensive Support and Care

Substance use counselors play a crucial role in providing comprehensive support that addresses both mental health challenges and substance use disorders. Implement a holistic approach considering the individual’s physical, cognitive, and social well-being.


To effectively address this challenge in medicated-assisted treatment, here are some Action Steps to take:

  1. Individualized Treatment Plans: Develop personalized treatment plans that address each client’s needs and goals.
  2. Psychoeducation: Educate clients about substance use disorders and mental health challenges. Educating the client can empower them to participate actively in their recovery.
  3. Support Network Development: Help clients build a strong support network. A support network can include friends, family, support groups, and other community resources.



In conclusion, substance use counselors play a pivotal role in addressing various challenges in Medication-Assisted Treatment (MAT). By equipping themselves with the proper knowledge and skills, they can provide comprehensive support and care to their clients, aiding them on their recovery journey.

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