Medication-assisted treatment (MAT) is one of the most widely researched and effective approaches for treating opioid and alcohol addiction. Unfortunately, though, many people misunderstand it. MAT uses therapeutic doses of FDA-approved medications in combination with talk therapy to manage withdrawal symptoms and cravings for better recovery outcomes—it does not replace one addiction for another.
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What is MAT, and why is it used in addiction recovery?
MAT is an evidence-based approach that combines medication with counseling and behavioral therapies. Medication plans are not one-size-fits-all, but they are carefully monitored and part of a comprehensive recovery plan.
The most common medications used are medications for opioid use disorder (MOUDs) and medications for alcohol use disorder (MAUDs). These are widely studied and effective because of the way opioids and alcohol affect the brain. Both substances cause strong cravings—often part of other withdrawal symptoms—when someone stops using them. MAT can be a safe, effective part of the entire treatment process. It can manage withdrawal symptoms but also reduces cravings, making it easier for clients to engage with the therapy process.
Read more: What is medication-assisted treatment?
How MAT incorporates medications for opioid use disorder (MOUDs)
Opioids, including prescription painkillers, heroin, fentanyl, and more, affect how the brain regulates pain, reward, and stress. When someone stops using opioids, they can have severe withdrawal symptoms and seemingly insatiable cravings. Spikes of pain and even depression during withdrawals can make cravings even stronger, increasing the risk of relapse. When someone relapses, they have a higher chance of overdose since their tolerance has decreased.
MOUDs reduce withdrawal symptoms, making them more manageable, and control cravings. This gives people entering recovery a reliable way to be more stable so they can engage with the process. One 2020 study revealed that MOUDs increased retention and completion in short-term residential treatment.
Common medications for opioid use disorder
There are several FDA-approved MOUDs. Some work in different ways and have different effects. An addiction treatment provider selects an option based on someone’s medical history, substance use, and level of care.
- Methadone: A full opioid agonist that helps reduce withdrawal symptoms and cravings by activating opioid receptors in a controlled, long-acting manner. It is typically dispensed through licensed treatment programs and closely monitored.
- Buprenorphine: A partial opioid agonist with a “ceiling effect,” which helps lower the risk of misuse while easing withdrawal symptoms and cravings.
- Naltrexone: An opioid antagonist that blocks the effects of opioids. It does not relieve withdrawal symptoms but may be used after detox to help prevent relapse.
How MAT supports medications for alcohol use disorder (MAUDs)
Similar to MOUDs, medications for alcohol use disorder also manage cravings and lessen withdrawal symptoms. Withdrawals after stopping alcohol use are generally more severe and can even be dangerous. MAUDs can block the “intoxicating” feelings of alcohol and even cause discomfort if someone drinks while taking them. This helps reduce the risk of relapse.
And MAUDs are effective. A 2024 study showed that starting medications for alcohol use disorder after being hospitalized for alcohol-related issues reduced rates of returning to the hospital or death by over 50%.
Common medications for alcohol use disorder
There are also several FDA-approved medications used for alcohol use disorder.
- Naltrexone: May help reduce cravings and decrease the pleasurable effects of alcohol.
- Acamprosate: Often used to support abstinence by reducing persistent symptoms associated with early sobriety.
- Disulfiram: Creates an unpleasant physical reaction if alcohol is consumed, serving as a deterrent when used under medical supervision.
Benefits of medication-assisted treatment
When integrated into a comprehensive treatment plan, medication-assisted treatment offers several well-documented benefits:
- Reduces withdrawal symptoms and cravings
- Improves engagement and retention in treatment
- Supports participation in counseling and therapy
- Reduces relapse and overdose risk, particularly for opioid use disorder
- Improves daily functioning and quality of life
- Supports individualized, long-term recovery planning
While MAT is not appropriate for everyone, its benefits make it a safe, effective option for many recovering from opioid or alcohol addiction.
MAT pros and cons
Pros
- Evidence-based support for recovery
- Stabilizes brain chemistry affected by addiction
- Improves treatment retention and engagement
- Reduces overdose risk for opioid use disorder
- Supports daily functioning and recovery work
Cons and considerations
- Potential medication side effects
- Requires ongoing medical oversight
- Not appropriate for everyone
- Access and availability challenges for some medications
- Stigma and misinformation
Common myths about MAT
MAT is just trading one addiction for another
MAT medications are prescribed in controlled doses and monitored by medical professionals. When used appropriately, they do not produce euphoric effects and are intended to support stability, not substitution.
MAT is only short-term
There is no universal timeline for MAT. Duration is individualized and based on clinical progress and recovery needs. Research has shown that some people benefit from longer-term plans (12+ months) while others see most benefits in getting stable during detox.
MAT is only for severe addiction
MAT can work for many different levels of addiction severity. Addiction treatment providers create individualized plans based on substance use patterns and goals for recovery.
MAT increases overdose risk
When properly prescribed and monitored, MAT actually reduces overdose risk, particularly for opioid use disorder.
MAT works without counseling
MAT is most effective when combined with counseling, behavioral therapies, and recovery support.
MAT works best with counseling and a full continuum of care
A comprehensive treatment plan is the best place to start for most people. This approach improves the effectiveness of FDA-approved MAUDs and MOUDs. Medications help stabilize physical symptoms, while counseling and behavioral therapies address the emotional, psychological, and behavioral aspects of addiction.
Through individual counseling and group therapy, clients can explore underlying contributors to substance use, manage co-occurring mental health symptoms, develop coping strategies, and build relapse prevention skills. Coordinated care between medical providers and therapists ensures treatment remains aligned with recovery goals.
MAT can be part of detox, residential, and outpatient levels of care, and providers can adjust the intensity as recovery progresses.
What to expect when starting MAT
When you make the choice to start medication-assisted treatment, you’ll have support from the very first step. Here’s what you can expect from Santé:
- A confidential assessment to understand your substance use history and medical needs
- Finding a level of care, such as detox, residential, or outpatient treatment
- A personalized medication and therapy plan developed by medical professionals
- Ongoing monitoring and support to adjust care as recovery evolves
It’s a big decision, but our team is here to answer any questions you might have. From what you should bring to treatment to how your family can be involved, no question is too big or too small.
Your next step: Explore treatment options at Santé Center
MAT is a safe, effective part of treatment for many of our clients. Along with counseling, relapse prevention planning, and support for co-occurring mental health conditions, you’ll have comprehensive support at every turn. Our care teams work closely with you to ensure your treatment aligns with your recovery goals.