Opioid addiction is one of Oregon’s biggest problems, and medication-assisted treatment is one way to reclaim your life. Medication-assisted treatment (MAT) helps to overcome Opioid Use Disorder (OUD) issues through a three-pronged approach:
- Medications to reduce the cravings
- Counseling to address the life issues that may have contributed to the addiction
- Support of family and friends for encouragement
How does MAT work?
The medications used in MAT are designed to greatly reduce your cravings. They work on the same places in your body that opioids do, so you feel less of a need for those opioids. The best dose also avoids withdrawal symptoms. Buprenorphine and methadone are taken once a day. Naltrexone can be taken daily as a tablet or as a once a month injection.
Who is MAT best for?
Anyone who has been diagnosed with Opioid Use Disorder should consider MAT. Talk to your provider to see if MAT is right for you.
How do I know which medication is best for me?
Every MAT patient is different, and picking the medication that is best for you is important. Talk with a provider who has some experience with MAT and who also is willing to get to know you. These medications are commonly used:
- Methadone is an opioid with a very long half-life. This means that it will stay in your body for a long time. The length of time varies by person, too. While it is in your system, you do not go into withdrawal, and other opioids won’t have an effect because it’s in the way. But because it stays in the body for a long time, it can also be dangerous. It is administered in a clinic setting on a daily basis to begin with to ensure it is being used safely. You can begin taking some doses home if urine drug screens show you are not taking unprescribed medication and are participating in the counseling part of your treatment.
- Buprenorphine prevents you from going into withdrawal and reduces cravings. It can also be prescribed and taken home, so there is no need for daily clinic visits. Frequency of clinic visits is high when you are just getting into treatment, stabilizing on medication, and recovering the rest of your life. With time and signs of safety, visits can become less frequent. Buprenorphine is recommended for pregnant women for their safety and to prevent the fetus from experiencing withdrawal.
- Naloxone is an opioid rescue medication. When there is an opioid overdose, someone else can give you naloxone to reverse the overdose. When you are receiving MAT and getting off of opioids, your tolerance goes down. This means that if you relapse, it is more likely that you will overdose. For this reason, it is highly recommended that you carry naloxone during MAT. A pharmacist and any other prescribing professional can prescribe naloxone to you.
- Suboxone is the brand name of the combination of buprenorphine and naloxone. The combination is designed to reduce misuse of buprenorphine. The presence of naloxone will reverse the effect of buprenorphine if the tablet is crushed or chewed.
- Naltrexone is used if you have already been without opioids for about a week. When you take naltrexone, relapsing and taking an opioid is ineffective. It blocks the euphoric and sedative effects that opioids cause. Naltrexone is used to prevent relapses and the possible overdoses that a relapse can cause. Additionally, naltrexone blocks the intoxicating and euphoric effects of alcohol and so is useful for patients struggling with both opioid and alcohol use disorders.
Why do I have to be in withdrawal before I get my first dose?
You must be in the early stages of withdrawal before your first dose of methadone or buprenorphine to ensure that other opioids are out of your system. For methadone, this is important so that you do not experience an opioid overdose. For buprenorphine, this is important because if you have opioids in your system, buprenorphine can quickly cause withdrawal symptoms. Your provider will determine the best starting dose of methadone or buprenorphine by treating the withdrawal symptoms you are experiencing.
How do I find a provider?
If you feel MAT is appropriate for you, talk to your health care provider. They will be able to help you connect with appropriate resources. Additionally, you can visit the:
How long will I stay on MAT?
There is no defined timeline for MAT. Therapy is specialized for each individual. Sometimes a few weeks is enough. Sometimes months are needed. Even if treatment takes years, during the entire time you are making progress, you are successful! Sometimes people are told they are not in recovery because they are on MAT. This is like telling a diabetic they are not making progress because they are on insulin. MAT treats the changes in the brain caused by opioid use disorder. Recovery means becoming reliable again – taking care of any legal concerns; becoming a parent, spouse, or partner again; getting a job or volunteering; taking care of your health – rejoining society and knowing that you lead a valuable life.
For more information, see: