What Is Medication-Assisted Treatment for Alcohol Use Disorder?
Key takeaways:
Medication-assisted treatment (MAT) uses medications to directly address substance use disorders.
MAT uses a combination of psychotherapy and medication, and it can help you start or continue recovery from alcohol.
Like other medical treatments, MAT for alcohol carries some risks and isn’t right for everyone. Talk with your provider about the pros and cons.
If you have been unable to quit alcohol on your own, medication-assisted treatment (MAT) is a great way to address your problem drinking patterns. MAT uses a combination of medicines and therapy. It could be a helpful treatment to lower risks and improve your health.
Continue reading to learn more about MAT for alcohol use disorders. We’ll cover how it works and what you can do to make it more successful.
How does medication-assisted treatment work for an alcohol use disorder?
Medication-assisted treatment (MAT) is the use of medications for the treatment of a substance use disorder. The medications directly target and normalize the brain chemicals disrupted by alcohol. MAT can help you achieve sobriety and maintain recovery. It can also help prevent future dangers like overdose and death.
MAT is used to treat:
Alcohol use disorders
Opioid use disorders
Nicotine use disorders
With MAT, the goal is to reduce withdrawal symptoms and limit cravings linked to drinking. As the treatment manages these uncomfortable symptoms, alcohol has less control over your life. You are free to live without the distraction of alcohol.
MAT is not about just substituting one drug for another drug. Instead, MAT targets the chemical imbalances in your body to leave you in a healthier state. MAT is also supervised by a healthcare provider, so you’re less likely to misuse the medications.
The medications in MAT are the main part of the treatment, but no MAT program is complete without professional therapy options. With both counseling and behavioral therapies, MAT acts in different ways to address your health and well-being.
Does medication-assisted treatment work alongside other treatment options for substance use?
MAT uses a combo of medication and therapy, and so it is a complete treatment option. Some people may want extra treatments. Most of the time, MAT can work with other treatments.
In addition to MAT, you could:
Take part in support groups like Alcoholics Anonymous (AA)
Take medications for other mental health issues like depression and anxiety
Attend outside group, individual, or family therapy options
MAT for alcohol use disorder is flexible and can go with other professional and nonprofessional services. Just be sure to talk to your treatment team about any combination of services that may not be best for your specific situation.
What kinds of medications can you take for an alcohol use disorder?
There are three medications available for treating alcohol use disorder. These medications do not cure addiction or instantly take away all the symptoms. But they can really improve your results.
The most common medications for alcohol use disorder are:
Acamprosate (Campral): Acamprosate is best for people who have already stopped drinking. It can help by adjusting the balance of your brain chemicals. Acamprosate can also improve sleep, lower anxiety, and improve your mood.
Disulfiram (Antabuse): This medication works by triggering very unpleasant side effects from alcohol, which can deter you from drinking. If you drink after taking disulfiram, you could experience vomiting, chest pains, and trouble breathing.
Naltrexone (Vivitrol and Revia): Naltrexone blocks the pleasurable “buzz” you would feel from alcohol. It does this by working with your body’s opioid system. Without the pleasant effects, there’s less motivation to drink.
MAT programs use some less-common medications like topiramate (Topamax) and gabapentin (Neurontin). These medications may help balance your brain chemicals. They can also encourage recovery and abstinence from alcohol.
Where can you get medication for alcohol use?
MAT is a specialized treatment, so you may not be able to get it from your primary care doctor. Instead, you should consider seeking out mental health or substance use experts for MAT options.
To find local service providers near you, check out the Behavioral Health Treatment Services Locator from the Substance Abuse and Mental Health Administration (SAMHSA). The National Institute on Alcohol Abuse and Alcoholism (NIAAA) also offers an Alcohol Treatment Locator where you can search for providers and programs that offer MAT for alcohol addiction.
What are the risks of medication-assisted treatment?
Like any other treatment, MAT comes with risks. No one can promise you’ll be completely safe. But the risks of MAT are much lower than the risks if you keep drinking.
One of the major risks of MAT are side effects from the medications. Some common MAT side effects include:
Nausea, vomiting, and diarrhea
Anxiety or depression
Feeling weak or tired
Poor appetite
Sleeping too much or too little
Dizziness
Numbness
You could experience suicidal thoughts, confusion, or an allergic reaction to the medication. Always contact your healthcare provider, 9-1-1, or the National Suicide Prevention Lifeline at 1-800-273-8255 immediately if these issues appear.
Another challenge of MAT is the need to use your medications at the required schedule. You must take options like disulfiram, topiramate, and gabapentin at least once per day. Forgetting could put your treatment at risk. On the other hand, the Vivitrol injection lasts for 30 days, which helps maintain the effects.
The final risk of MAT is you could keep drinking. This could happen because the treatment doesn’t work for you. Or you could keep drinking, even though you’ve had medication and therapy. If this happens, don’t be too discouraged. Check in with your treatment team to find a better combination of services that can help you reach your goals.
When can you start MAT for alcohol use?
You can start MAT at any time, but there are some limitations. Some medications are OK to start immediately. Other medications require you to be abstinent for a period of time.
Oral naltrexone: can start at any time as long as you don’t use opioids
Injectable naltrexone: can start whenever you stop drinking
Disulfiram (Antabuse): can start as soon as there is no alcohol in your body
Acamprosate (Campral): can only start after all withdrawal symptoms have concluded, which is usually 5 days after the last drink
Topiramate (Topamax) and gabapentin (Neurontin) are not approved by the FDA for MAT. Prescribers will use their best judgment on when to start.
How long does it take for medication-assisted treatment to help with an alcohol use disorder?
One great benefit of MAT is the speed of action. Some medications produce quick results. Disulfiram (Antabuse) can create its unpleasant effects just 10 minutes after you drink alcohol. Naltrexone, especially the injectable option, could work quickly as well.
With other medications, it may take some time to get their greatest benefit. They may not be able to repair chemical issues in the brain in a day or two. Be patient and be sure to take your medication as prescribed to boost effectiveness. Attending therapy and/or a support group can help you cope as you wait for the medication to start working.
How long do you have to be on MAT for alcoholism?
The best substance use treatments are completely individualized for you. They consider your situation, stress levels, and support system. The amount of time that your provider recommends you stay on MAT will depend on your unique situation.
MAT does not have a time limit. Your prescriber will tailor treatments to your symptoms and goals. Always keep the lines of communication open and work together as a team for best results.
The bottom line
Studies show that getting any type of help for alcohol addiction can help you achieve recovery. MAT for alcohol use disorders is an effective form of treatment that you should consider. With the approach of medication and therapy, you could have your best chance at a lasting recovery.
If you or someone you know is having thoughts of suicide, you’re not alone and help is available. Call the National Suicide Prevention Lifeline at 1-800-273-8255 or text HOME to 741741 to reach the Crisis Text Line.
References
Anton, R. F., et al. (2020). Efficacy of gabapentin for the treatment of alcohol use disorder in patients with alcohol withdrawal symptoms: A randomized clinical trial. Jama International Medicine.
Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury. (2016). Medications for the treatment of alcohol use disorder.
