What is Medication Assisted Treatment (MAT)?
MAT is an evidence-based approach for treating opioid use disorder (OUD). It involves the use of specific medications, usually in combination with counseling and social support programs, to help guide individuals toward recovery.

Types of MAT
‍There are three medications approved by the U.S. Food and Drug Administration (FDA) to treat OUD: methadone, buprenorphine, and naltrexone. When taken as prescribed, all three have been shown to be safe and potentially effective.

These medications are separated into two main categories: opioid agonists and antagonists. 

Opioid agonists are medications that bind to the same receptors in the brain as other opioids (ex. heroin and morphine) do. Because of this, opioid agonists produce similar, but weaker effects as other opioids, and therefore relieve symptoms associated with opioid withdrawal and craving.

‍Opioid antagonists are the opposite of agonists. They bind to and physically block the receptors in the brain that opioids bind to. This stops any opioid from binding to its receptors, thus blocking the effects of opioids.

Meet the Medications
Methadone
Methadone is a long-acting opioid agonist. “Long-acting” means that its effects are felt much more gradually than stronger opioids (such as morphine). It relieves opioid withdrawal symptoms and cravings.

Because Methadone is an opioid, it has the potential to be abused. It is important to use it as prescribed under a doctor's supervision, and (as with all other medication-assisted treatments) it is most effective when combined with ongoing counseling. Methadone is usually taken for a minimum of 12 months, and can be gradually reduced over time.

Buprenorphine
Buprenorphine is a partial opioid agonist. This means that is produces similar effects as methadone, but these effects are less strong. Buprenorphine also works by relieving cravings and withdrawal symptoms. It is commonly used in combination with Naltrexone, which is known as Suboxone.

Like Methadone, Buprenorphine has potential to be abused. The best results from using this medication are obtained along with counseling.
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Naltrexone
Naltrexone is an opioid antagonist, meaning it binds to opioid receptors in the body and brain and blocks them. Therefore, if someone tries to take an opioid while on Naltrexone, their opioid receptor sites will be blocked and they won’t be able to feel the effects of the opioid.

Naltrexone is NOT an opioid (unlike methadone and buprenorphine). It is not addictive, and it will not cause withdrawal symptoms once discontinued. Naltrexone has been shown to reduce cravings and relapses. It comes in two forms: pill-form, and injectable (called Vivitrol).

People taking opioids must typically wait a week before starting Naltrexone. Taking Naltrexone before this can cause precipitated withdrawals - withdrawals that come on much faster and stronger than regular withdrawals.