One of the sharpest controversies in the field of addiction treatment revolves around whether medication-assisted treatment (MAT) is just replacing one addiction with another. Much of the MAT controversy in addiction treatment centers on the use of methadone, buprenorphine, and naltrexone to treat drug addiction. These medications interact with the same opioid receptors in the brain that are affected by drugs like fentanyl, heroin, and opium. Given the ongoing debate, this article will address questions like why is MAT controversial in addiction treatment.
If you’re wondering what the answer is regarding this controversy, the short version is that MAT techniques are clinically proven to support successful long-term recovery. Arguably even more critical, MAT methods can significantly cut overdose risks. After all, a person can’t recover from addiction if they don’t make it.
We aim to address the stigma surrounding the MAT controversy in addiction treatment by examining the concerns some people have. It is also worth looking at what MAT is and does, and why it is an increasingly popular approach to addiction treatment. This article will also break down MAT myths and facts so you can make a more informed decision if you or a loved one is seeking treatment.
How Does Medication-Assisted Treatment Support Recovery?
Multiple medications are used as part of MAT and addiction recovery. Methadone, buprenorphine and naltrexone all have FDA approval for use with MAT for addiction, particularly opioid addiction recovery.
Addiction treatment specialists often prefer MAT in opioid treatment programs because it addresses some of the core problems that hamper recovery efforts. Particularly, MAT methods reduce withdrawal symptoms, making individuals feel more physically comfortable during the process. Likewise, those in recovery are less likely to experience drug cravings while in an MAT program. Addiction recovery medication also tends to stabilize brain chemistry, making support efforts that much more effective.
An additional benefit of some medications is that they block opioid effects. For individuals who are struggling with relapse risks after they complete a treatment program, these medications can help in their efforts to embrace a life in recovery.
MAT Options and Their Effects
It is important to understand that specific medications serve different roles. Methadone is a full agonist, meaning it activates the same receptors in the brain that opioids do. Unsurprisingly, this is a reason why people exploring options wonder if methadone is just trading one addiction for another.
Buprenorphine, on the other hand, is a partial agonist, meaning it activates some of the receptors. This makes medications like Suboxone ideal for treating withdrawal symptoms and managing cravings in many cases.
Naltrexone is an antagonist. It is the opposite of an agonist in that it blocks any type of high, even if a person uses drugs.
MAT in a Larger Recovery Context
It is crucial to note that MAT is not a single solution. It belongs in a larger recovery context that involves other critical interventions, such as counseling, behavioral therapy and lifestyle changes. The support system surrounding an individual in recovery also influences their likelihood of success.
Why Is MAT Controversial in Addiction Treatment?
Long-term MAT effects are a relevant part of the discussion, particularly when it comes to the fear that some people will suffer withdrawal symptoms if they stop taking the medication. This often runs alongside the notion that “real recovery” means total abstinence, an idea perpetuated by some individuals who have successfully quit cold turkey.
Several common criticisms emerge in the ongoing MAT controversy in addiction treatment, especially regarding long-term medication use and perceived dependence. There is also a belief that Suboxone and methadone dependence are just as bad as addiction to heroin and other drugs. Even among people who support MAT in principle, there is some debate about methadone vs. Suboxone based on the belief that full agonists are worse than partial agonists. Opponents of MAT frequently express concerns that medications used in treatment do not address the root causes of addiction.
Is MAT Replacing One Addiction With Another?
MAT lowers relapse rates and overdose deaths, and a large body of scientific research strongly supports this claim. For instance, a Pew Research study found that MAT is the most effective treatment option for opioid use disorder available. This class of medications stabilizes brain chemistry, reducing intense cravings and withdrawal symptoms in ways that promote recovery. Naltrexone receives especially high marks in treating individuals who aggressively seek the euphoria or high associated with opioid use.
The big takeaway from the research is that medications associated with MAT programs do not offer a high. Instead, they stabilize individuals so they can function while taking the steps necessary to regain control over their lives.
MAT Is a Life-Saving Recovery Tool
One important point to understand is that addiction is a mental health disorder, not just a bad habit. The reality is that individuals need to be physically and mentally stable in order to engage fully in the recovery process. To succeed, they must be able to focus on therapy, work, and relationships, which are essential for rebuilding a healthy life.
Is MAT Safe?
MAT is a safe and effective treatment option when administered correctly and under the supervision of healthcare providers. Regular monitoring ensures that the treatment stays aligned with the person’s evolving needs and that any risks are managed appropriately. In addition, studies show that people prescribed methadone or buprenorphine are 50% less likely to die of an overdose than people not given this type of medication. MAT and relapse prevention are oftentimes two sides of the same coin, with long-term recovery rates higher when people combine MAT with therapy.
How Does Medication-Assisted Treatment Support Recovery?
MAT in long-term addiction treatment is about distinguishing between dependence and addiction. There is a relevant concern about the fact that some agonists and partial agonists foster dependence in weighing medication-assisted treatment pros and cons. However, this type of therapy can play a vital role in supporting recovery by breaking the cycle of addiction.
What Are the Risks of Long-Term MAT Use?
Even if you have a positive view of MAT, it is important to understand the risks. First, methadone generally has a higher risk profile than Suboxone. As a full agonist, methadone carries similar risks to other opioids, including:
- Dependence
- Withdrawal symptoms
- Respiratory and cardiac issues
- Adverse drug interactions
Tapering is possible, but some people stay on methadone long term. If they have ongoing pain management issues, there is a risk that they may develop a tolerance. This may require dose adjustments or even moving on to another drug for maintenance.
Suboxone is generally seen as safer. However, there are liver toxicity risks at higher dosages, and this is especially important if you have an existing liver condition. Suboxone also can increase a rare risk of serotonin syndrome in individuals who are using certain antidepressants.
Mitigation is important. By working with a professional, you can regularly monitor adverse effects and focus on using the lowest effective dose.
The Role of Personal Choice in Recovery
At the end of the discussion regarding the pros and cons of medication-assisted treatment, personal choice is the defining factor. MAT isn’t for everyone, and that’s OK.
Given the connection between Suboxone and relapse prevention, however, it can be valuable to consider MAT as a proven method to increase your chances of maintaining long-term sobriety. Before you make your personal choice, take the time to understand the MAT myths and facts. Scientific studies on MAT effectiveness consistently show that it reduces the risk of overdose deaths while also limiting the difficulties associated with withdrawal symptoms.
Medication Stigma in Addiction Recovery
At a societal level, the MAT controversy in addiction treatment contributes to ongoing stigma and barriers to access, even among healthcare professionals. There are still many myths about Suboxone and methadone that keep people, even some medical professionals, from supporting medication-assisted treatment programs. Even in the face of overwhelming evidence, some people advocate abstinence-based recovery vs. MAT. That is fine for them, but it shouldn’t prohibit you or a loved one from exploring MAT programs.
On the other hand, many people forgo MAT because they’re afraid of judgment. However, addiction treatment should focus on saving lives, and that includes shifting the conversation surrounding MAT. Friends, family members, and other loved ones need to:
- Learn how MAT works
- Support each person’s recovery path
- Avoid using shaming language
Keep in mind that society rarely gets judgmental about long-term drugs that have no association with use disorders. For instance, few think a person with diabetes using insulin is wrong, even if they are in some way dependent on the drug to get well.
A Path to Recovery
There is a credible concern about developing dependence on both methadone and Suboxone. However, at Health Care Resource Centers, we believe the benefits of medication-assisted treatment outweigh the risks, especially its role in preventing overdose deaths and breaking the destructive cycle of addiction. If you’re interested in exploring MAT for addiction treatment, we are here for you. Contact us today to discuss your options.
