Medication-Assisted Treatment (MAT)

What is MAT and what does it do?

Medication-Assisted Treatment (MAT) is an approach to treating Opioid Use Disorder (OUD) as a chronic disease that focuses on stabilizing patients, reducing their symptoms, and helping them remain in recovery. These goals are achieved by taking medication on a regular basis that allows patients to function without misusing opioids. When dosed correctly, individuals on MAT will experience reduced withdrawal symptoms while also not getting high. Overall, MAT reduces the illicit use of opioids, reduces the chances of an overdose, and increases the likelihood someone will remain in treatment.

MAT Type:	Methadone	Naltrexone (Vivitrol)	Buprenorphine/Naloxone (Suboxone)	Buprenorphine (Subutex, Butrans)
Purpose of Treatment:	Medically supervised withdrawal, maintenance	Prevention of relapse to opioid misuse, following medically supervised withdrawal	Medically supervised withdrawal, maintenance	Medically supervised withdrawal, maintenance
How the medication works:	Reducing or eliminating withdrawal symptoms, blunting or blocking the effects of illicit opioids, reducing or eliminating cravings to use opioids	Blunting or blocking the effects of illicit opioids, reducing or eliminating cravings to use opioids	Reducing or eliminating withdrawal symptoms, blunting or blocking the effects of illicit opioids, reducing or eliminating cravings to use opioids	Reducing or eliminating withdrawal symptoms, blunting or blocking the effects of illicit opioids, reducing or eliminating cravings to use opioids
Setting Administered:	Opioid Treatment Programs (OTP) only	Office-based treatment or specialty substance use treatment programs, including OTPs	Opioid Treatment Programs (OTP) and at offices/clinics with waivered prescribers	Opioid Treatment Programs (OTP) and at offices/clinics with waivered prescribers
Dose frequency:	Can be taken once daily	Can be taken once every four weeks	Can be taken once daily	Can be taken once daily
Location/frequency of office visits:	OTP only: At first individual will need to go in 6-7 times per week. Additional methadone take-home doses are possible at every 90 days of demonstrated progress in treatment.	Office/clinic: Varies from weekly to monthly	Office/clinic: Begins daily to weekly, then tailored to patient’s needs OTP: Can treat with buprenorphine 6–7 days/ week initially; take-homes are allowed without the time-in-treatment requirements of methadone	Office/clinic: Begins daily to weekly, then tailored to patient’s needs OTP: Can treat with buprenorphine 6–7 days/ week initially; take-homes are allowed without the time-in-treatment requirements of methadone
Route of Administration:	A tablet or liquid swallowed	An injection into the muscle tissue	A film dissolved on the cheek or under the tongue, or a pill dissolved under the tongue	A pill dissolved under the tongue

Frequently Asked Questions

How do I know which MAT option is best for me?

There is no “one size fits all” solution for treating Opioid Use Disorder. Treatment plans will be individualized for each person based on their needs by their medical provider. Often, two factors are heavily considered when deciding which MAT option is best for an individual: the frequency someone has the ability to access a treatment location and their insurance coverage.

How long will I be on MAT?

This depends on each individual’s situation and needs. Many people with OUD benefit from treatment with medication for varying lengths of time, including lifelong treatment. Ongoing outpatient medication treatment for OUD is linked to better outcomes and sustained recovery than treatment without medication. Even so, some people stop using opioids on their own; others recover through support groups or specialty treatment with or without medication.

What is an Opioid Treatment Program?

Opioid Treatment Programs (OTPs) are accredited treatment programs with a SAMHSA certification and a Drug Enforcement Administration registration. These requirements allow OTPs to administer and dispense medications such as methadone and buprenorphine, used for MAT for patients with addiction to opioids. OTPs also provide medication like naltrexone that does not require this level of regulation. In addition, OTPs must provide other treatment services such as assessments, testing, and counseling.

What is Medically Supervised Withdrawal?

Medically supervised withdrawal allows patients to take methadone or sometimes buprenorphine over a short period of time to minimize symptoms of withdrawal. This process can also be referred to as detoxification. Over the course of a few days or weeks, providers slowly taper the amount of medication that is given to a patient, until it is discontinued. Medically supervised withdrawal is a necessary step for individuals with OUD to complete before taking naltrexone. All opioids, including methadone and buprenorphine, must be out of someone’s system 7-10 days before being given a dose of naltrexone. It is important to note that patients who go through medically supervised withdrawal are at risk for opioid overdose if they should start using again because their tolerance for opioids has lowered.

Information on this page came from Medications for Opioid Use Disorder – SAMHSA and a webinar by Washington Poison Center titled: Narcan & Medication-Assisted Treatment.

Organizations with MAT Waivered Providers

To find an organization near you that offers MAT services go to https://search.warecoveryhelpline.org/.