If you’ve been in substance use recovery, you may have heard about MAT and MOUD for addiction treatment. They both refer to medications used when treating opioid use disorders. They’re often used as if they are the same thing. However, there are differences. In this guide, we’ll dig into the similarities and differences between MAT and MOUD. Both are vital parts of opioid dependence treatment. You’ll learn about the critical reasons for knowing what each approach is for and why it matters what we say about them. Medications for opioid dependence can save lives. The stigma surrounding these treatments may stand in the way for people who need them.
MAT vs. MOUD in Addiction Treatment
MAT is part of a larger opioid use disorder treatment plan, and MOUD is a stand-alone treatment, according to a Treatment Improvement Protocol (TIP) from SAMHSA. We explain these differences more below and why they matter.
Medically Assisted Treatment (MAT)
Medically Assisted Treatment (MAT) is a term addiction professionals have used for years. It refers to short-term medication therapy for alcohol and opioid use disorders. These treatments are part of a larger treatment and recovery plan. As explained by a resource on the SAMHSA website, MAT is used with counseling and behavioral therapy. This holistic approach addresses addiction from several angles.
The role of medication in addiction treatment
The concern over the use of MAT comes from the role medication has in addiction treatment. Medication was first used as an add-on to the usual treatments. The primary method approach has been counseling therapy which addresses how thoughts, emotions, and behaviors work together. From this viewpoint, medication has had a supporting role. Now, research has backed medication as an effective stand-alone treatment. The term MAT has the word “assisted” in it, still defining the medicine as secondary. Current methods now use medication with or without counseling therapy. It’s considered a safe and effective treatment on its own. This treatment method is called Medications for Opioid Use Disorder (MOUD), and it’s described more in the next section.
MAT is still part of addiction treatment
When using short-term therapies for addiction, MAT is still an appropriate term. For example, medical detox is one type of MAT. It can be a vital step in a person’s recovery process. However, the move toward MOUD may reduce the stigma surrounding addiction medications. It defines medication as primary treatment instead of something on the side. MOUD treatments are explained more in the section below.
Medications for Opioid Use Disorder (MOUD)
MOUD stands for Medications for Opioid Use Disorder. It’s a term used by addiction and medical professionals. As described earlier, MAT considers medication a short-term intervention. It’s part of a larger treatment approach. By contrast, MOUD uses medication as a stand-alone treatment for opioid addiction. The medication itself may be used for months or years. It’s much like taking heart medication or insulin. The medication helps a person manage triggers and cravings. With this support, a person can make other life changes to help their recovery. The duration of treatment depends on a person’s needs. At this time, there’s no standard length for MOUD treatment. Some people may go without relapsing after several months of MOUD. For others, using the medication for years may be a safer option. The most appropriate use of MOUD is whatever supports a person’s long-term health. People using MOUD in recovery get the chance to:
- Limit exposure to things and people that remind them of using substances.
- Make healthy choices like improving diet, exercise and sleep.
- Manage other life areas like parenting, relationships and work.
Ending treatment is often a primary goal. It could mean a person has settled into a stable period of recovery. But ending MOUD too early can put a person at risk of using opioids again. If this happens, they may be in danger of injury, hospitalization or overdose. Ongoing medication can limit or prevent these harmful outcomes and can be a safer option.
What medications are used to help with MOUD?
These medications work by connecting with receptors on nerve cells in the brain. Nerve cells communicate with body chemicals called neurotransmitters. They interact with receptors like a lock and key, as explained by the Recovery Research Institute. Medications and other substances like opioids can also interact with receptors. This process creates reactions like euphoria, sedation or stimulation. Medications used to treat opioid addiction are designed to occupy the same receptors. The result is receptors that are activated or blocked. According to the National Institute on Drug Abuse, each type of medication works in different ways to reduce withdrawal symptoms. Let’s look at some of the more commonly used medications described below.
Agonist medications and opioids activate receptors in similar ways. However, agonists are activated more slowly. The National Institute on Drug Abuse explains that for people with opioid dependence, agonist medications reduce cravings and withdrawal symptoms. They do not produce euphoria. Part of the stigma with addiction medications is due to a misunderstanding. Some believe that this method swaps one dangerous, addictive drug for another one. Agonists do have the potential for abuse. But they can be a life-saving treatment when monitored by medical professionals. Methadone Methadone is one of the more well-known medications used to treat opioid use disorders. According to NAMI.org, methadone can be taken by mouth as a liquid or tablet, or injection. Buprenorphine Buprenorphine is a partial agonist, according to the University of Arkansas Medical Sciences. It produces a lower level of activation than methadone. The release into the body is slow and steady. For a person with opioid dependency, this approach prevents highs and crashes. It can prevent dangerous cycles of cravings and withdrawal.
Antagonist medications block or interfere with a cell’s activity. They work by slowing down the biological reaction that feeds into substance misuse. Because the cells are not activated, antagonist medications are not addictive. They have no potential for abuse, according to SAMHSA. Naltrexone Naltrexone is an injectable long-acting medication for treating opioid use disorders. According to SAMHSA, one caution with naltrexone is an increased sensitivity to opioids. If someone uses opioids after taking Naltrexone, their body may react to smaller amounts, increasing the risk of overdose and death. Naloxone Naloxone blocks the effects of opioids in a person’s body to stop and reverse opioid overdose, as stated in a research document from the National Center for Biotechnology Information. The effects are short-term. Other medical treatments must be used along with this medication. It is injected into the muscle, under the skin or into the blood, or inhaled from a nasal spray.
Benefits of medication for opioid addiction treatment
According to the National Institute on Drug Abuse, research has shown that medications to treat opioid disorders are effective. Their use can save lives and give people a chance to develop other life areas in recovery. By reducing the chances of an overdose, these medications help people stay in treatment. A study from The Recovery Research Institute suggests that people gain the most by using medication for at least six months. Each person’s needs may be different. Treatment completion is lower with these medications. But sometimes, staying on the treatment is a safer and more effective recovery goal.
Concerns about people not pursuing this treatment
Unfortunately, according to the National Institute on Drug Abuse, these medications are not widely used for opioid addiction. Some treatment programs can’t give these medications. And some individuals with addiction don’t know to ask about this treatment. Quitting “cold turkey” without medical help is dangerous. The risk of relapse is high, even after abstaining for some time. Cravings and withdrawal symptoms can draw a person back to patterns of misuse. Without medical monitoring, a person may struggle with withdrawal symptoms. The Recovery Research Institute states that the risk of opioid use is reduced with the help of medication.
Using the right term matters when treating opioid disorders
Opioid misuse is a disease that requires long-term treatment. The National Academy of Medicine states that part of the stigma with addiction treatment is perception.
Stigma can prevent people from getting treatment
Some believe that addiction is due to lifestyle choices and willpower. If a person wants to get better, all they need to do is try harder. Stigma prevents people from getting the help they need. Just getting started with treatment can be a challenge. One misconception is that these medications are a simple drug swap. In other words, a person trades one addictive drug for another. It’s not true recovery until they move past the medication. This viewpoint stems from misunderstanding and is incorrect. A person can be in remission while using medication. Some treatment programs still do not encourage the use of medication support. While this may not be intentional, this view may cloud the message about MOUD. As more learn about the benefits of MOUD, this trend may change. But until then, access to MOUD is not reaching everyone it needs to.
Viewing opioid addiction as a health condition
The long-term disease approach is not new. Addiction and medical providers have been moving in this direction for years. It puts opioid addiction in a similar light as other long-term conditions. Consider how doctors treat heart disease and Type 1 diabetes. Treatment plans for both conditions use medication and behavioral changes. As the use of MOUD expands, a health-based approach could become the norm for opioid use disorders. MAT is also a vital aspect of addiction recovery. As part of a larger treatment, a short-term intervention like medical detox is essential. Detox can help a person move from acute addiction to a more stable period of recovery. However, MAT is not considered a long-term treatment. After a short-term MAT, MOUD may be used for ongoing health and recovery.
MOUD and MAT for opioid addiction treatment
The bottom line is that MOUD saves lives. But stigma stands in the way of people getting this life-saving treatment. Using the term MOUD for opioid addiction treatment may seem like a small step. But just one word can do a lot to shift public perception. As MOUD becomes connected with medical treatment, the stigma about treatment can begin to erode. If you need to learn how MOUD or MAT could help you or a loved one, call us at our P.A.T.H. clinic.
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