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Medication-Assisted Treatment (MAT) Explained

MAT combines medication with counseling for effective treatment. Understand how it works and when it might be the right approach.

Medication-Assisted Treatment (MAT) uses FDA-approved medications, combined with counseling and behavioral therapies, to treat substance use disorders. Despite stigma, MAT is one of the most effective evidence-based approaches—particularly for opioid and alcohol addiction.

"MAT isn't 'trading one drug for another.' It's using medication to stabilize brain chemistry so real recovery work can begin. We don't shame diabetics for using insulin."

Medications for Opioid Use Disorder

Buprenorphine (Suboxone, Subutex)

A partial opioid agonist that reduces cravings and withdrawal symptoms without producing the high of full opioids. Can be prescribed by certified physicians in office settings.

Best for: Most opioid use disorders; allows outpatient treatment; lower overdose risk

Methadone

A full opioid agonist that prevents withdrawal and cravings. Must be dispensed through certified clinics with daily (initially) dosing.

Best for: Severe, long-term opioid addiction; those who haven't succeeded with buprenorphine; provides structure

Naltrexone (Vivitrol)

An opioid blocker that prevents opioids from producing effects. Available as daily pill or monthly injection. Requires complete detox first.

Best for: Highly motivated individuals; those preferring non-opioid option; available as monthly shot

Medications for Alcohol Use Disorder

Naltrexone

Reduces the pleasurable effects of alcohol and cravings. Available as daily pill or monthly injection (Vivitrol).

Acamprosate (Campral)

Helps restore brain chemistry balance disrupted by chronic alcohol use. Reduces protracted withdrawal symptoms.

Disulfiram (Antabuse)

Creates unpleasant reaction if alcohol is consumed. Works as deterrent for those with strong motivation.

The Evidence for MAT

Research consistently shows MAT for opioid use disorder:

  • Reduces overdose deaths by 50% or more
  • Increases treatment retention significantly
  • Decreases illicit drug use
  • Reduces criminal activity
  • Improves employment and social functioning

Addressing Common Concerns

"Isn't this just replacing one addiction with another?"

No. When used properly, MAT medications normalize brain function without producing intoxication. The person can work, drive, and live normally—which isn't possible while actively addicted to heroin or alcohol.

"Will they need medication forever?"

Some people taper off after months or years of stability. Others benefit from long-term maintenance—just as someone with diabetes may need lifelong insulin. Duration is individualized.

"Isn't it better to be completely drug-free?"

For some, abstinence-only works. But for many—especially with severe opioid addiction—MAT prevents death and allows recovery. Being alive and stable on medication beats relapse and overdose.

Important

MAT works best when combined with counseling and behavioral therapy. Medication alone isn't sufficient—but medication plus therapy can be transformative.

Matthew Mattone

Questions about MAT?

Let's Discuss All Options

I can help you understand whether MAT might be appropriate and find programs that offer comprehensive medication-assisted treatment.