Myth vs. Fact: The Truth About Medication Assisted Treatment (MAT)

Every day, approximately 130 people in America die from opioid overdose. And for the first time in our nation’s history, people are now more likely to die from an accidental opioid overdose than a car crash.

Medication assisted treatment (MAT) – a combination of counseling and an FDA-approved medication – is considered the gold standard treatment for opioid use disorder. Medications approved for use in treatment include:

• Methadone: An opiate agonist that binds to receptors in the brain, effectively blocking cravings and eliminating withdrawal symptoms.
• Buprenorphine (Suboxone): A partial opioid agonist that produces weaker euphoric effects and less respiratory depression. It has a “ceiling effect” that lowers the risk of misuse, dependency, and side effects.
• Naltrexone: An opioid antagonist (Vivitrol) that binds and blocks the brain’s opioid receptors and reduces opioid cravings. There is no abuse and diversion potential with naltrexone.

Despite its proven benefits, MAT continues to carry a stigma that’s rooted in misinformation and confusion. As a result, patients and their loved ones are often convinced to steer clear of a treatment that could improve the odds of successful recovery.

Ending the stigma surrounding medication assisted treatment and educating the public is a key step in providing treatment access and combating the opioid epidemic. With that in mind, here are some MAT truths everyone needs to know.

Myth: MAT is just substituting one addiction for another.

This statement reflects a large misunderstanding of addiction. By definition, addiction is much more than just the act of abusing substances regularly. Addiction also involves the driving compulsion to find and use drugs at all costs, even in the face of life-destroying consequences.

Methadone and buprenorphine (Suboxone) are opioids, and they do create physical dependence. But dependence is not the same as addiction. Dependence doesn’t involve behavioral impairments. MAT medications are proven to help people disengage from drug-seeking behaviors and become more receptive to behavioral treatments. This makes it possible for a patient to function normally, attend school or work, and participate in other forms of treatment or recovery support services to help them become free of their substance use disorder over time.

Patients who want to stop taking buprenorphine or methadone can work with their clinicians to slowly taper off the medications and avoid withdrawal symptoms.

Myth: MAT medications are nothing more than a crutch to prevent real recovery.

People who participate in MAT programs can – and do – achieve “true recovery.” As the name medication assisted treatment implies, medications are only one part of MAT. The medications help to normalize brain chemistry, which allows people to successfully participate in counseling and behavioral interventions that support long-term recovery.

Science shows that people who participate in medication assisted treatment:

• Are less likely to use illicit drugs
• Do not experience euphoria, sedation, or other functional impairments
• Do not meet diagnostic criteria for addiction, such as loss of will to control drug use

MYTH: If you take medications like Suboxone or methadone, you aren’t really in recovery.

If MAT is truly making a positive difference someone’s recovery, why is it still considered “controversial?” And if someone is no longer abusing the substance that turned life upside down, why shouldn’t they be in recovery?

Unfortunately, some treatment programs and support groups define “success” as total abstinence from MAT medications along with other drugs and alcohol. While this may be a realistic approach for some, many people, especially those who have struggled for years with heroin and other opioids, need medication as part of a comprehensive recovery plan. It’s the same with diabetes – some people can manage their disease with diet and exercise, others need medication to control the disease.

MAT helps more people stay in treatment and remain sober for the long-term. At the correct dosage and taken as directed, patients do not feel high and they do not struggle with withdrawal symptoms. One study even found that patients taking an opioid agonist 18 months post-treatment are twice as likely to be sober from opioid pain killers than those not taking an opioid agonist.

MYTH: Buprenorphine is bought and sold illegally on the streets. It can’t be legitimate medication for opioid addiction.

The truth about buprenorphine, according to research and addiction specialists alike, is that it’s mainly sold on the streets not as a drug to get high…but as a way for people to avoid the miserable symptoms of withdrawal. For example, when someone can’t find heroin or afford to buy OxyContin, they turn to Suboxone.

It’s also purchased illegally by people who want to enter recovery, but they either can’t afford it, face long wait-list times to enter a program, or have no access to MAT services.

In reality, the fact that people buy Suboxone to avoid withdrawal symptoms actually proves it is a legitimate medication for treating opioid addiction. And advocates agree that, if people had easier access to buprenorphine, they wouldn’t need to turn to the black market.