Medicated Assisted Treatment clininc: Image Source: Dania Maxwell / Los Angeles Times

Medicated Assisted Treatment; Good or Bad?

Substance use disorders can have devastating effects on individuals and their communities. Substance use counselors must understand the value of medicated assisted treatment (MAT) and harm reduction in addressing these issues. This article aims to provide insights into the significance of medicated assisted treatment and harm reduction, offering guidance and support to substance use counselors unfamiliar with these approaches.

Understanding Substance Use Disorders and the Role Medicated Assisted Treatment Plays

Substance use disorders, including opioid use disorder (OUD), are chronic conditions that require comprehensive treatment. Addiction is a complex disease that affects individuals’ brains, behavior, and overall well-being. Substance use counselors recognize substance use disorders’ seriousness and long-lasting impact.

However, many counselors are not educated about the importance of medicated-assisted treatment in their educational pursuits.

The Role of Medicated Assisted Treatment (MAT) in Harm Reduction

Medicated assisted treatment (MAT) is valuable in treating substance use disorders, particularly Opioid Use Disorder. It is also an integral harm reduction strategy.  MAT combines medications with counseling and behavioral therapies to provide a holistic and practical treatment approach.

The FDA: Approved Medications to Support Recovery

There are three FDA-approved medications used in medicated assisted treatment facilities.

These include

• methadone,
• buprenorphine, and
• naltrexone.

These medications have been proven safe and effective when used in conjunction with counseling and psychosocial support.

Methadone

Methadone is a long-acting opioid used in Opioid Treatment Programs to prevent withdrawal symptoms and reduce cravings for opioids. It is a Schedule II opioid narcotic and requires close monitoring due to the risk of overdose. Methadone treatment aims to stabilize individuals and support their recovery journey.

Methadone Maintenance Treatment Programs (MMTP) have been the gold standard for people with heroin use disorders.

However, methadone clinics have been scrutinized repeatedly by the general public, politicians, Alcoholics Anonymous, and many people who refuse to read the research and evidence supporting this life-saving drug.

Buprenorphine

Buprenorphine is a Schedule III opioid narcotic that can be used in an Opioid Treatment Program (another name for medicated assisted treatment) or prescribed by specially-trained physicians. It is a partial opioid agonist, meaning it works similarly to methadone but does not induce a complete opioid response in the body.

Buprenorphine helps normalize brain chemistry, reduces cravings, and blocks the euphoric effects of opioids.

Naltrexone

Naltrexone, available as a tablet or long-acting injection, is an opioid antagonist. Unlike other medications, it does not produce opioid effects. Naltrexone works by blocking the euphoric effects of opioids and encouraging sobriety. It is not a controlled substance and can be prescribed by regular doctors.

The Benefits of the Harm Reduction Strategy: Medicated Assisted Treatment 

Medicated assisted treatment (MAT) offers several benefits in the treatment of substance use disorders:

1. Normalizing brain chemistry: Medications help restore balance in the brain, reducing cravings and withdrawal symptoms.
2. Blocking euphoric effects: Medicated assisted treatment (MAT) medications block the pleasurable effects of opioids, discouraging their misuse.
3. Relieving physiological cravings: Medications alleviate the intense desire for opioids, supporting individuals in their recovery journey.
4. Reducing the risk of overdose: Medicated-assisted treatment (MAT) medications can prevent fatal overdoses by blocking or reducing the effects of opioids.
5. Providing a comprehensive approach: Medicated-assisted treatment (MAT) combines medication with counseling and behavioral therapies for a holistic treatment approach.

The Importance of Continuing Medicated assisted treatment (MAT)

Substance use counselors should be aware that MAT is a long-term treatment. The need for continuing medicated assisted treatment (MAT) should be evaluated periodically, and there is no maximum recommended duration of maintenance treatment. For some individuals, treatment may continue indefinitely to support their recovery and prevent relapse.

Embracing Harm Reduction Principles and Medicated-Assisted Treatment (MAT)

Harm reduction is a crucial approach in substance use counseling that focuses on minimizing the negative consequences of substance use rather than strictly promoting abstinence. It recognizes the reality that not all individuals are ready or able to stop using substances immediately.

Reducing Harm and Promoting Safety

 aim to reduce harm and promote safety among individuals who continue to use substances:

1. Overdose prevention education: Provide individuals with education on recognizing and responding to opioid overdoses, including using naloxone, an overdose-reversal medication.
2. Naloxone distribution: Encourage the distribution of naloxone directly to individuals at risk of overdose to increase accessibility and save lives.
3. Good Samaritan laws: Inform individuals about laws that protect against drug offenses for those seeking medical help during an overdose.
4. Safer substance use practices: Promote harm reduction techniques such as using clean needles, practicing safe sex, and avoiding sharing drug paraphernalia.

Non-judgmental and Client-Centered Approach

Harm reduction embraces a non-judgmental and client-centered approach, recognizing that each individual’s journey is unique. Substance use counselors should respect clients’ autonomy and meet them where they are in their recovery process. This approach fosters trust, creates a safe therapeutic environment, and increases the likelihood of engagement in treatment.

Addressing Stigma and Bias

Stigma and bias surrounding substance use disorders and medication-assisted treatment can hinder individuals from seeking help and impact their overall well-being. Substance use counselors play a vital role in dispelling myths and addressing misconceptions to create a supportive and inclusive environment.

Educating Others and Challenging Misinformation

Substance use counselors can combat stigma and bias by educating colleagues, friends, family members, and the community about the nature of substance use disorders and the effectiveness of medicated-assisted treatment. By providing accurate information, counselors can challenge misconceptions and promote understanding.

Promoting Recovery Capital and Goals

Counselors should emphasize the importance of recovery capital and support clients in setting and achieving their treatment goals. By highlighting the positive impact of medicated-assisted treatment on individuals’ lives, counselors can help shift the narrative and reduce stigma.

Empowering Patients and Advocating for Their Rights

Substance use counselors should empower patients by informing them of their rights and advocating for access to comprehensive treatment options, including medicated-assisted treatment. Encouraging self-advocacy and providing resources can help individuals navigate barriers and fight against discrimination.

Conclusion

Medicated-assisted treatment and harm reduction are vital components of substance use counseling. By understanding the benefits of MAT and embracing harm reduction principles, counselors can provide effective support to individuals with substance use disorders. It is essential to address stigma, challenge bias, and promote a client-centered approach to foster positive outcomes and empower individuals on their recovery journey. Remember, every person deserves compassion, understanding, and access to evidence-based treatment options.