About Treatment
Why medication assisted treatment (MAT)?
Research has indicated that medication assisted treatment (MAT) is an effective treatment for heroin and prescription opioid use disorder when measured by:
Reduction in the use of illicit drugs
Reduction in criminal activity
Reduction in needle sharing
Reduction in HIV infection rates and transmission
Cost-effectiveness
Reduction in commercial sex work
Reduction in the number of reports of multiple sex partners
Improvements in social health and productivity
Improvements in health conditions
Retention in addiction treatment
Reduction in suicide
Reduction in lethal overdose
Sources:
Amato L, Davoli M, Perucci C, Ferri M, Faggiano F, Mattick RP. An overview of systematic reviews of the effectiveness of opiate maintenance therapies: available evidence to inform clinical practice and research. Journal of Substance Abuse Treatment 2005;28(4):321-29.
Dole VP, Nyswander ME, Kreek MJ. Narcotic blockade. Archives of Internal Medicine 1966;118:304-09.
Individuals are less likely to become involved in criminal activity while enrolled in comprehensive medication assisted treatment:
Patients who remain in opioid maintenance treatment for long periods of time are less likely to be involved in criminal activity than patients in treatment for short periods.
The availability of comprehensive medication assisted treatment in a community is associated with a decrease in that community’s criminal activity, particularly theft.
Sources:
Hubbard RL, Marsden ME, Rachal JV, Harwood HJ, Cavanaugh ER, Ginzburg HM. Drug Abuse Treatment: A National Study of Effectiveness. Chapel Hill: University of North Carolina Press, 1989.
Mattick RP, Breen C, Kimber J, Davoli M. Maintenance therapy versus no opioid replacement therapy for opioid dependence. The Cochrane Database of Systematic Reviews, Issue 2, 2003.
The likelihood of becoming and remaining employed is increased for patients who participate in comprehensive opioid treatment programs:
In an early study of 100 chronic heroin users who were admitted to maintenance treatment, the employment rate increased from 21 percent at admission to 65 percent 1 year later (Maddux and McDonald, 1973; Maddux and Desmond, 1979).
The Powers and Anglin (1993) study of 933 heroin addicts in opioid maintenance treatment demonstrated that rates of employment (and marriage) increased during treatment.
Sources:
Maddux JF, Desmond DP. Crime and treatment of heroin users. The International Journal of the Addictions 1979;14(7):891-904.
Powers KI, Anglin MD. Cumulative versus stabilizing effects of maintenance. Evaluation Review 1993;17(3):243-70.
The treatment of opioid use disorder utilizing a combination of medication and individual/group counseling is the current accepted “standard of care” for pregnant women:
There is consensus that two of the three FDA-approved medications (methadone and buprenorphine) can be safely administered during pregnancy with little risk to woman and fetus.
Medication assisted treatment is necessary to prevent relapse to illicit opioid use and thus to maintain optimal health during pregnancy.
Subjecting a pregnant woman to withdrawals or putting a pregnant woman through detoxification, if not closely monitored on an inpatient basis, can put both the mother and fetus’s life at risk.
A pregnant woman experiencing withdrawals may result in fetal birth defects or even fetal death.
Women who are enrolled in medication assisted treatment during their pregnancy give birth to babies who are substantially healthier and experience less neonatal abstinence syndrome (withdrawals) - if any at all - than babies born to women who are actively using illicit substances.
Sources:
Effective Medical Treatment of Opiate Addiction: A National Consensus Panel Statement. National Institutes of Health (NIH).1998.
Jones HE, Fischer G, Heil SH, et al. Maternal Opioid Treatment: Human Experimental Research (MOTHER)--approach, issues and lessons learned. Addiction. 2012;107 Suppl 1(0 1):28-35. doi:10.1111/j.1360-0443.2012.04036.x
Understanding Medication Assisted Treatment
Opiate Addiction (2 Part Video) from HBO's Addiction Documentary
Helpful Links
The Tennessee REDLINE for alcohol, drug, problem gambling, and other addiction information and referrals: 1-800-889-9789
The Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health & Human Services: https://www.samhsa.gov/medication-assisted-treatment
The National Institute on Drug Abuse (NIDA) within the National Institutes of Health (NIH):
and
The American Association for the Treatment of Opioid Dependence (AATOD):
https://www.aatod.org/opioid-education/frequently-asked-questions
The Tennessee Department of Mental Health & Substance Abuse Services (TDMHSAS):