Medication Assisted Treatment (MAT) refers to any treatment for a Substance Use Disorder (SUD) that includes pharmacological intervention as part of a larger, more comprehensive addiction treatment plan. At EHN Canada MAT involves the use of medications approved by Health Canada in combination with education, psychological counseling, behavioral therapies and peer support to provide a comprehensive, evidence based approach to care.
Medical professionals currently have three types of Medication Assisted Treatments or therapies (MATs) at their disposal for treating patients with SUD including Opioid Use Disorder (OUD). MAT options include:
- Buprenorphine– is a partial opioid agonist which means that although it can produce typical opioid effects and side effects such as euphoria and respiratory depression, its maximal effects are less than those of full agonists like heroin and methadone
- Naltrexone– is a non-addictive opioid antagonist that blocks the effects of opiates. It is typically administered as a daily pill in Canada however, it is readily available in monthly injection form and implants in other parts of the world
Suboxone is a brand name medication that contains two active ingredients: Buprenorphine and Naloxone. Naloxone, sold under the brand name Narcan, is an opiate antagonist (like Naltrexone) and is used to block the effects of opioids and reverse overdose.
Suboxone therefore, is an “opioid agonist/ antagonist” that blocks the reinforcing properties of opiates while alleviating craving for the drug and reducing withdrawal symptoms. Suboxone is administered daily in the form of dissolving tablets or cheek film. It is non-addictive and is not typically abused by patients. Suboxone has become the gold standard in MAT for opiate dependence.
- Methadone– While becoming less widely used, Methadone is an opioid agonist that does not block the reinforcing properties of opiates but does prevent cravings and withdrawal symptoms while taking it. Methadone is dispensed daily in liquid form in specialty regulated clinics. It requires laboratory testing and monitoring and can be abused because of its addictive properties.
Although methadone is commonly used to ease opioid withdrawal and has been an effective drug for many patients, EHN-Canada supports the use of Suboxone because most medical experts view Suboxone as a better alternative with fewer side effects and a significantly better patient safety profile. There is also much less potential of abuse and overdose with Suboxone as compared to Methodone and it is far less complicated to administer and monitor. In addition, the use of Suboxone is in keeping with many patients’ goals of using Medication Assisted Treatment (MAT) for a transitional period as opposed to long-term, indefinite maintenance.
Because of the unique challenges in addressing opiate addiction, and because of its unique vulnerability to relapse, accidental overdose and death, Edgewood provides Medication Assisted Treatment (MAT) as an adjunct to psychological and behavioral therapies. This “holistic” clinical approach is supported by a high degree of scientific evidence, especially in the treatment of Opioid Use Disorder. Because MAT helps decrease withdrawal symptoms and cravings, patients are better able to engage in treatment and focus on learning new skills and ways of relating to people, places and things that could trigger relapse. Indeed, with the support of evidence based psychological interventions such as Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT), patients have a much higher likelihood of achieving long-term recovery which may eventually include abstinence from drugs in many cases.
Scientifically Proven Benefits of Medication Assisted Treatment (MAT)
- Higher levels of engagement in psychological and behavioral intervention
- Increased rate of treatment compliance and retention in treatment
- Decreased opiate use
- Decreased criminal activities
- Lower incidence of overdose
- Minimization of overdose deaths and improved survival rate
It is important to note that Medication Assisted Treatment (MAT) for Substance Use Disorder (SUD) needs to be managed by a well trained, credentialed medical professional. There are known side effects associated with of MAT and drug-drug interactions with other prescribed medications have also been documented in the clinical literature. Also, MAT may be counter-indicated for some patients with specific medical conditions. For example, anyone who suffers from kidney problems should not take the drug Acamprostate which is used in the treatment of alcohol dependence, while Naltrexone can be hazardous to anyone with preexisting liver damage. Because each individual can react differently to MAT, it is important that patients are instructed to contact their physician immediately if they are having any adverse health conditions as a result of these medications.
As part of EHN Canada’s approach to addiction treatment, our inter-professional treatment team works with each patient to determine the care plan that will best meet their unique needs. Some patients may receive Suboxone for detox purposes in easing withdrawal symptoms while others may receive a recommendation for maintenance Suboxone therapy. EHN Canada is the only Canadian provider facilitating access to an extended-release injection of Naltrexone known as Vivitrol. Vivitrol is an MAT that is proven to dramatically decrease cravings for both opiates and alcohol. This medication has been a major advancement in the field in terms of preventing relapse.