Medication-Assisted Treatment (MAT): What It Is & How It Works

Medication-Assisted Treatment, or MAT, is one of the most evidence-based ways to treat opioid and alcohol addiction. It combines FDA-approved medications with counseling and behavioral therapy.

Despite how well it works, MAT is often misunderstood. Some people think using medication to treat addiction just swaps one drug for another. That’s not how it works, and the misunderstanding keeps people from treatment that could save their lives.

What MAT Actually Does

Addiction changes brain chemistry and neural pathways. Those changes don’t simply reverse when someone stops using. MAT medications work by:

• Reducing withdrawal symptoms during detox
• Blocking the rewarding effects of opioids or alcohol
• Reducing cravings that would otherwise lead to relapse
• Stabilizing brain chemistry to allow participation in therapy and recovery work

Medications for Opioid Use Disorder

Buprenorphine (Suboxone, Subutex)

Buprenorphine is a partial opioid agonist. It activates opioid receptors in the brain, but has a ceiling effect: it doesn’t produce the euphoria of full opioids at normal doses. It significantly reduces withdrawal symptoms and cravings. Certified physicians can prescribe it, and it can be taken at home, which makes it accessible and private.

Methadone

Methadone is a full opioid agonist. It must be dispensed through federally regulated clinics. It has a long track record of success for people with severe opioid use disorder. Because it’s dispensed daily, at least at first, it provides built-in structure and accountability.

Naltrexone (Vivitrol)

Naltrexone blocks opioid receptors, which removes the reward from using opioids. Unlike buprenorphine and methadone, it has no addiction potential. It comes as a daily pill or a monthly injection called Vivitrol. The catch: it requires complete detox first. A person can’t be physically dependent on opioids when they start naltrexone.

Medications for Alcohol Use Disorder

• Naltrexone: Reduces the pleasurable effects of alcohol and helps reduce craving
• Acamprosate (Campral): Reduces the post-acute withdrawal discomfort that makes early sobriety difficult
• Disulfiram (Antabuse): Causes an unpleasant physical reaction when alcohol is consumed, which serves as a deterrent

Does MAT Work?

The evidence is clear. MAT significantly improves outcomes for opioid and alcohol use disorder. Research consistently shows it reduces illicit drug use, lowers overdose deaths, improves treatment retention, and reduces addiction-related crime. The Substance Abuse and Mental Health Services Administration (SAMHSA) calls MAT a gold-standard treatment.