Medication Assisted Treatment in New Hampshire

Here at Addiction Recovery Services of New Hampshire, we’re proud to support medication-assisted treatment (MAT) as part of our wide range of services. MAT is the use of certain medications, in combination with behavioral therapies and counseling, to treat substance use disorders with an intensive approach that treats the whole person, not just their addiction.

MAT can be a very powerful tool in helping someone suffering from alcohol or opioid use disorder achieve long-term, lasting recovery. Medications used in MAT have all been approved by the Food and Drug Administration (FDA) for this purpose. These FDA-approved medications include buprenorphine and methadone for treating opioid addiction, acamprosate for treating alcohol use disorder, and naltrexone, which is effective in treating addiction to either substance. 

The goal in prescribing these medications is to relieve physiological cravings and normalize bodily functions while also preventing withdrawal symptoms.

Opioid Withdrawal Symptoms

After an extended period of opioid use, a person’s body and brain begin to adjust to the presence of the drug. This leads to physical dependence, which makes the basis for opioid addiction. If that person abruptly stops using opioids, they will experience withdrawal symptoms that are both intense and uncomfortable. The goal in using many of the MAT medications is to avoid these symptoms entirely so the person is able to completely focus on recovery.

The length of time someone used opioids, how they were used, and the amount used each time are all factors that can affect the severity of withdrawal symptoms once the person stops using. The severity and length of withdrawal will vary from person to person, but there are some symptoms that are experienced by everyone.

Opioid drug use can suppress many of the functions of the central nervous system such as controlling breathing rate, heart rate, and body temperature. Opioids work by binding to receptors in the brain, causing the brain to release an unnatural level of the chemicals that are responsible for feelings of pleasure. After an extended period of opioid use, the brain begins to adjust for this new source of pleasure chemicals and stops producing them on its own. When a person stops using opioids suddenly, the brain and body are left to readjust, leading to all of the negative symptoms of opioid withdrawal.

The symptoms of opioid withdrawal can vary from mild to severe, and while they can be extremely uncomfortable, they are not generally seen as life-threatening. Some of these symptoms include:

• • • Abdominal pain and cramps
    • Nausea, diarrhea, and vomiting
    • Restlessness
    • Irritability and agitation
    • Goosebumps and tremors
    • Fatigue
    • Depression and anxiety
    • Increased blood pressure and rapid heart rate
    • Impaired breathing and muscle spasms
    • Difficulty feeling pleasure or positive feelings
    • Extreme opioid cravings

Because of the severe nature of opioid withdrawal, it is highly recommended that opioid users detox in a medically supervised environment.

Medication-Assisted Treatment (MAT) for Opioid Addiction

MAT is typically used in treating addiction to both prescription and illegal opioid-based drugs. Some of these drugs include:

• • • Morphine
    • Heroin
    • Fentanyl
    • Hydrocodone
    • Vicodin
    • Morphine
    • Oxycodone
    • Carfentanil
    • Codeine

When used as prescribed, opioids can be a useful medication in treating people who suffer from chronic pain. Opioids make it more difficult for the brain to detect pain by changing the body’s perception of pain. This class of drugs also comes with unpleasant side effects that may include sedation, dizziness, nausea, constipation, vomiting, physical dependence, and slowed breathing.

The medications used in MAT (naltrexone, buprenorphine, and methadone) work by interacting with the same receptors in the brain the harmful opioids interact with but without causing the euphoric “high” that leads to addiction. These medications also curb withdrawal symptoms, allowing for the person to focus on addressing any underlying causes of addiction through therapy and counseling.

The different medications used in MAT interact with opioid receptors in different ways. For example, buprenorphine and methadone relieve the symptoms of withdrawal and suppress cravings. Naltrexone totally blocks the effects of opioids at receptor sites in the brain and is used in patients who have already gone through opioid detox.

While MAT is mainly used to treat opioid use disorders, in many cases, MAT can be used to treat alcohol use disorders as well. Naltrexone is often used in these cases as it has been found to be effective in reducing cravings for both opioids and alcohol.

Alcohol Withdrawal Symptoms

Much like the opioid withdrawal symptoms, alcohol withdrawal symptoms can be extremely uncomfortable. While opioid withdrawal symptoms are not generally believed to be life-threatening, alcohol withdrawal can be potentially fatal. Because of this, it’s very important to seek detox under medical supervision.

The symptoms of alcohol withdrawal can begin to take effect within 12 to 24 hours of a person’s last drink. For people with long-term, severe alcohol use disorder, the effects of alcohol withdrawal can start to show themselves within just a few hours. When a person is a habitual alcohol user, their lifestyle may be such that they are able to keep an elevated blood alcohol level at all times. If this alcohol concentration in the blood dips even slightly, it can trigger a series of negative reactions in the body and brain.

Mild symptoms of alcohol withdrawal can start to show up within 6 hours of a person’s last drink. These symptoms may include:

• • • Headache
    • Anxiety
    • Vomiting
    • Insomnia or trouble sleeping
    • Sweating
    • Nausea

While these symptoms can be very uncomfortable and potentially dangerous, they are not believed to be life-threatening. The most dangerous symptoms of alcohol withdrawal occur when someone is experiencing a syndrome known as sudden alcohol cessation (SAC). SAC occurs in the early stages of detox when the body is in shock from the sudden lack of alcohol. The longer a person has been addicted to alcohol, the more severe the consequences of SAC may be. The majority of deaths that happen during alcohol withdrawal occur during this stage of detox.

When someone is going through SAC, they will go through a wide range of negative, and potentially dangerous, symptoms. Some of these include:

• Heart issues: The sudden lack of alcohol in the bloodstream can cause disturbances or changes in the rhythm of the heart. This can affect the contractions of the heart, or how the heart beats normally. Sometimes these effects are serious enough to potentially cause heart stoppage and death.

Although heart failure is typically only seen in older, long-term alcohol users who have already started to experience alcohol-related damage to the heart, heart problems can occur in anyone who tries to quit alcohol without proper medical help.

• Delirium tremens (DTs): Symptoms of DTs can begin to show up within 48 to 96 hours after a person quits drinking. Someone who is experiencing the effects of DTs may become extremely agitated, confused, and disoriented. They may also have visual and auditory hallucinations. This means they may see or hear things that aren’t actually happening as well as other delusions.

They can also develop an extreme sensitivity to light and sounds. Extreme cases of DTs may also cause a person to fall into a deep, coma-like state, sleeping for days at a time. In this stage of detox, a person is at the highest risk for seizures that can potentially be deadly.

• Malnutrition: People suffering from an addiction to alcohol often neglect the nutritional needs of their bodies. Over time, this can lead to a lack of essential vitamins and minerals the body needs to function properly. Even alcohol users who consume proper amounts of nutrients may have trouble with malnutrition. This is because, over time, alcohol begins to damage the lining of the stomach. This makes it much more difficult for the stomach to absorb essential nutrients

People who are going through alcohol detox are often given nutritional supplements and medications to help offset these nutritional shortages.

Medication-Assisted Treatment (MAT) for Alcohol Use Disorder

Alcohol use disorder can be a very challenging disorder to overcome. Alcohol is legally available at nearly every turn and is sold at local convenience stores, restaurants, bars, nightclubs, and liquor stores. It can also be difficult to avoid triggers for alcohol use because drinking is deeply ingrained in American culture and popular media. Everywhere we turn we are exposed to alcohol consumption in movies, music, and even advertisements. Alcohol consumption is often at the forefront of American social activities and celebrations.

This combination of widespread availability, legality, and acceptability of alcohol consumption can make it especially difficult to acknowledge and recover from alcohol use issues.

However, there is good news. The medications used in MAT at Addiction Recovery Services are effective in curbing the initial uncomfortable and potentially dangerous withdrawal symptoms. By making the symptoms of withdrawal a non-issue, people are able to start addressing the potential underlying root causes of their addiction without being distracted by cravings or discomfort.

FDA Approved Medications Used in MAT

As mentioned above, every medication used in a MAT program must be fully approved by the FDA. The screening process for FDA approval is lengthy and intensive to ensure these medications are both safe and effective.

Many arguments against the use of MAT in treating substance use disorder say these types of programs are simply substituting one addiction for another. This common false belief comes from a lack of understanding of the medications used in MAT, what they do, and what the goal of MAT actually is.

In reality, the medications used in MAT are designed to relieve physical and mental withdrawal symptoms and sometimes curb any drug cravings as a person learns how to sustain long-term recovery. By managing these negative feelings, medical professionals are able to identify and address any underlying causes of addiction or mental health disorders.

The specific medications used in MAT (with their brand names in parentheses) include:

• • • Naltrexone (Vivitrol and ReVia)
    • Naloxone (Narcan and Evzio)
    • Methadone (Diskets, Dolophine, and Methadose)
    • Buprenorphine (Belbuca, Buprenex, Butrans, and Subutex)
    • Buprenorphine and naloxone (Suboxone)
    • Acamprosate (Campral)

Is MAT Effective for Treating Patients With Substance Use Disorder?

Medication-assisted treatment has been shown to produce better outcomes across the board for patients suffering from opioid use disorder. One study conducted in Baltimore, Maryland, found that overdose deaths dropped when buprenorphine treatment became popular in the city. This study found a “significant and strong correlation” between the use of buprenorphine MAT and the fall in overdose deaths.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), MAT has been proved clinically effective for the treatment of opioid use disorder. It has also been found to significantly reduce the need for inpatient detox services for individuals suffering from substance use disorders. A large part of its effectiveness is due to the fact that MAT addresses the whole person and not just their addiction issues.

The goal of any addiction treatment program is to provide a person with the support and skills they need to find success in lifelong recovery. By providing an individually tailored treatment plan using both medication and behavioral therapy, the most effective MAT programs are able to address the recovery needs of most patients.

According to SAMHSA, MAT has also been shown to:

• • • Improve patient survival rates
    • Increase patient retention in treatment
    • Decrease illicit opioid use and other criminal activity among people with substance use disorders
    • Increase patients’ ability to get and keep jobs
    • Improve birth outcomes among women who have substance use disorders and are pregnant

Research has also shown that these medications and therapies can contribute to lowering a person’s risk of contracting HIV and hepatitis C by reducing the potential for relapse. This is believed to be due to the lowered potential of sharing used needles as relapse rates are lowered.

MAT Can Be a Powerful Tool in Your Intensive Outpatient Treatment at ARS

Whether you’re beginning or continuing your recovery, the intensive outpatient program (IOP) here at Addiction Recovery Services (ARS) can help guide you. When used alongside a treatment plan that treats the whole person and not just their addiction, MAT can be a powerful tool in helping you achieve your goals in recovery.

Our goal here is to always have the resources someone needs to steer their life in the direction they know it should be going. So much of the struggle with addiction is also a struggle with control. IOP at ARS is set up to help everyone involved achieve control again.

When you enroll for treatment at ARS, we want you to be prepared for what comes next. There may be some bumps in the road, but we know long-term recovery includes preparing for how those moments are handled.

Choosing outpatient rehab can be the first step someone takes toward recovery, but it doesn’t have to be. It’s just as viable as a next step for someone who has enrolled in and completed an inpatient rehab program.

Reclaim Your Health at ARS

Our mission is to never make you feel like a failure, no matter if that’s when you enter or when you are enrolled in IOP. It’s hard to begin, and it can be hard to maintain long-term recovery. We focus on harm reduction because we believe it’s been shown to help people recover effectively.

If you or someone you know is ready to begin recovery, let us know. ARS has multiple pathways to recovery, each defined by, and chosen based on, what the person in recovery needs. Give us a call at 978-228-5853 and let’s see about starting you on the way to recovery.

FAQs:

What are medication-assisted treatments?

Medication-assisted treatment (MAT) is the use of certain medications, in combination with behavioral therapies and counseling, to treat substance use disorders with an intensive approach that treats the whole person, not just their addiction.

What are the major components of medication-assisted treatment?

Medications that help manage the symptoms of withdrawal are regularly given to the person receiving treatment. While this is happening, the person is also attending group and individual therapy sessions and other therapeutic treatments. The goal of these treatments is to teach the person healthy coping skills and behaviors to allow them to live a life free of substance use.

What are the benefits of medication-assisted treatment?

The biggest benefit of MAT is that it helps curb the uncomfortable and potentially dangerous symptoms of withdrawal and allows for the person to explore the potential underlying causes of their addiction through different therapeutic treatments.

Does medication-assisted treatment work?

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), MAT has been proved clinically effective for the treatment of opioid use disorder. It has also been found to significantly reduce the need for inpatient detox services for individuals suffering from opioid addiction.