Medication Assisted Treatment (MAT) Overview

What is Medicated Assisted Treatment (MAT)?

MAT is the use of FDA approved medications in addition to behavioral therapies in order to decrease cravings and the side effects of withdrawal.

How do I know if MAT is right for me, and which one to choose?

If you or someone you know is having a problem with opioids or other substances and has decided to seek out information about treatment, you have taken the first step to recovery. The next step is to call the Illinois Opioid Helpline at 1-833-2FINDHELP. A qualified representative will provide you with resources and answer your questions. You can also visit these websites to learn more, including how to talk to your family and friends about MAT:

Comparing Medications for Opioid Addiction (From SAMHSA's Decisions in Recovery website)

	Who's it For?	Side Effects	Accessibility	Health Concerns	Starting/Stopping
Methadone	Able to get to an approved program Pregnant and post-partum women Have severe or chronic pain People being treated for HIV/AIDS People who do best with structured programs	Sweating Headache Constipation Drowsiness Nausea/vomiting Loss of appetite Decreased sexual desire/ability Weight gain Memory and concentration problems	Common forms Liquid Other forms may be available How do I take it? Taken once a day Daily dosing offered at approved programs Some take home dosing permitted More frequent if doing well in long-term treatment Cost *Cost varies depending on state, insurance, and other factors. Talk to provider about payment options.	Pregnancy and breastfeeding Safe to use during pregnancy and breastfeeding; very small amounts in breast milk Risk of withdrawal symptoms in infants born to mothers treated with methadone during pregnancy HIV May be used during treatment for HIV; watch for drug interactions that require dosage adjustments; talk with your doctors Hepatitis Has been used safely by people with hepatitis and by people being treated with interferon for Hepatitis C. Check with your doctors. Chronic pain *Usually safe to use methadone with other opioid medications prescribed for pain; dosage watched carefully due to overdose risk	When can I start? *Immediately How long do I take it? Most effective when used for longer periods of time, at least one year Safe for long term use as maintenance therapy Periodic assessment of ongoing treatment needs based on what is right for you What happens if I stop? Methadone withdrawal symptoms Dose can be gradually reduced instead What if I use opioid drugs on this medication? High risk of overdose May not have euphoric effect
Buprenorphine	Are best treated in doctors' offices Pregnant and postpartum women People being treated for HIV/AIDS Able to follow a treatment plan Motivated to try buprenorphine for MAT	Headache Stomach or back pain Constipation Nausea or Vomiting Difficulty falling asleep or staying asleep Sweating Mouth numbness, redness, or sores Tongue pain, swelling, or burning Excess fluid and swelling of feet or legs Blurred vision Intoxication (feeling lightheaded or drunk) Disturbance in attention Irregular heart beat (palpitations) Fainting Dizziness Sleepiness	Common forms Film or pill Other forms; seldom used for treating addiction How do I take it? Usually taken daily; must dissolve under the tongue or in mouth. Offered in various treatment programs Trained physicians provide it for office-based treatment Patients may get a prescription to take at home. Can be filled at any pharmacy Cost *Cost varies depending on state, insurance, and other factors. Talk to provider about payment options.	Pregnancy and breastfeeding Studies show buprenorphine safe during pregnancy and breastfeeding The form of buprenorphine that that does not contain naloxone is recommended during pregnancy and breast-feeding. Risk of withdrawal symptoms in infants born to mothers treated with buprenorphine during pregnancy HIV *May be used during HIV treatment. Smaller risk of drug interactions; talk with your doctors Hepatitis The form of buprenorphine that contains naloxone should not be used if patients have severe liver impairment. Has been used safely by people with hepatitis. Liver damage reported mostly in people who already had liver conditions. Check with your doctor. Liver function tests recommended. Chronic pain At high doses, buprenorphine can cancel out pain relieving effects of other opioid pain medications. Buprenorphine dosing for pain should be monitored carefully for overdose risk	When can I start? *12-24 hours after last use How long do I take it? Most effective when used for 9 months or longer Considered safe for long-term use Periodic assessment of ongoing treatment needs based on what is right for you What happens if I stop? Withdrawal, less intense, but unpleasant Withdrawal cannot be entirely "avoided" by gradually decreasing the buprenorphine dose. It is advisable to work with your doctor to gradually decrease your dose. What if I use opioid drugs on this medication? Moderate risk of overdose May cancel out pain relieving effects of other opioids
Naltrexone	Able to stop using for 7-10 days Mandated by court or employer People with alcohol problems Motivated to eliminate all opioids now Re-entering from prison or	Nausea or vomiting Diarrhea Stomach pain Decreased appetite Dry mouth Headache Difficulty falling asleep or staying asleep Diziness Tiredness Anxiety Joint pain or stiffness Muscle cramps Weakness Tenderness, redness, bruising, or itching at the injection site Constipation Irritability Tearfullness Increased or decreased energy Rash	Common forms Long-acting injection or pill How do I take it? Qualified medical professionals can prescribe the tablets or give injections Tablets are taken daily; long-acting injections are given monthly Outpatient programs may offer injectable naltrexone Cost Cost varies depending on state, insurance, and other factors. Talk to provider about payment options.	Pregnancy and breastfeeding Not recommended; no research on safety of use during pregnancy or breastfeeding HIV Safe to use with HIV medications; low potential for HIV drug interactions Hepatitis *Liver damage is possible at very high doses. Most studies report no liver damage at recommended doses. Work closely with your doctor before starting. Chronic pain May block effects of opioid medications taken for pain. Can cause withdrawal in people physically dependent on opioid pain medication, unless they stop all opioids 7-10 days before taking it. Non-opioid pain medication safe with naltrexone at all times. Talk with your doctor about naltrexone and pain.	When can I start? *After detox or 7-10 days after last use How long do I take it? Long-acting injectable form stays in effect for 30 days The length of treatment should be individualized and determined in consultation with your doctor. Most studies have been over a 5 month period or longer Approved for treating alcohol dependency What happens if I stop? A person who interrupts treatment with naltrexone and uses opioids sufficiently to become physically dependent again can experience withdrawal when naltrexone is re-introduced. High risk of overdose if opioid use is resumed - due to lowered tolerance. What if I use opioid drugs on this medication? May block effects of opioids Taking large amounts to override blocking effect has resulted in fatalities Naltrexone blocks the effects of an opioid and attempts to override the blocking can result in an opioid overdose.

Who's it For?

Side Effects

Accessibility

Health Concerns

Starting/Stopping

Methadone

Able to get to an approved program
Pregnant and post-partum women
Have severe or chronic pain
People being treated for HIV/AIDS
People who do best with structured programs

Sweating
Headache
Constipation
Drowsiness
Nausea/vomiting
Loss of appetite
Decreased sexual desire/ability
Weight gain
Memory and concentration problems

Common forms

Liquid
Other forms may be available

How do I take it?

Taken once a day
Daily dosing offered at approved programs
Some take home dosing permitted
More frequent if doing well in long-term treatment

Cost

*Cost varies depending on state, insurance, and other factors. Talk to provider about payment options.

Pregnancy and breastfeeding

Safe to use during pregnancy and breastfeeding; very small amounts in breast milk
Risk of withdrawal symptoms in infants born to mothers treated with methadone during pregnancy

HIV

*May be used during treatment for HIV; watch for drug interactions that require dosage adjustments; talk with your doctors

Hepatitis

*Has been used safely by people with hepatitis and by people being treated with interferon for Hepatitis C. Check with your doctors.

Chronic pain

*Usually safe to use methadone with other opioid medications prescribed for pain; dosage watched carefully due to overdose risk

When can I start?

*Immediately

How long do I take it?

Most effective when used for longer periods of time, at least one year
Safe for long term use as maintenance therapy
Periodic assessment of ongoing treatment needs based on what is right for you

What happens if I stop?

Methadone withdrawal symptoms
Dose can be gradually reduced instead

What if I use opioid drugs on this medication?

High risk of overdose
May not have euphoric effect

Buprenorphine

Are best treated in doctors' offices
Pregnant and postpartum women
People being treated for HIV/AIDS
Able to follow a treatment plan
Motivated to try buprenorphine for MAT

Headache
Stomach or back pain
Constipation
Nausea or Vomiting
Difficulty falling asleep or staying asleep
Sweating
Mouth numbness, redness, or sores
Tongue pain, swelling, or burning
Excess fluid and swelling of feet or legs
Blurred vision
Intoxication (feeling lightheaded or drunk)
Disturbance in attention
Irregular heart beat (palpitations)
Fainting
Dizziness
Sleepiness

Common forms

Film or pill
Other forms; seldom used for treating addiction

How do I take it?

Usually taken daily; must dissolve under the tongue or in mouth.
Offered in various treatment programs
Trained physicians provide it for office-based treatment
Patients may get a prescription to take at home.
Can be filled at any pharmacy

Cost

*Cost varies depending on state, insurance, and other factors. Talk to provider about payment options.

Pregnancy and breastfeeding

Studies show buprenorphine safe during pregnancy and breastfeeding
The form of buprenorphine that that does not contain naloxone is recommended during pregnancy and breast-feeding.
Risk of withdrawal symptoms in infants born to mothers treated with buprenorphine during pregnancy

HIV

*May be used during HIV treatment. Smaller risk of drug interactions; talk with your doctors

Hepatitis

The form of buprenorphine that contains naloxone should not be used if patients have severe liver impairment.
Has been used safely by people with hepatitis. Liver damage reported mostly in people who already had liver conditions. Check with your doctor. Liver function tests recommended.

Chronic pain

At high doses, buprenorphine can cancel out pain relieving effects of other opioid pain medications.
Buprenorphine dosing for pain should be monitored carefully for overdose risk

When can I start?

*12-24 hours after last use

How long do I take it?

Most effective when used for 9 months or longer
Considered safe for long-term use
Periodic assessment of ongoing treatment needs based on what is right for you

What happens if I stop?

Withdrawal, less intense, but unpleasant
Withdrawal cannot be entirely "avoided" by gradually decreasing the buprenorphine dose.
It is advisable to work with your doctor to gradually decrease your dose.

What if I use opioid drugs on this medication?

Moderate risk of overdose
May cancel out pain relieving effects of other opioids

Naltrexone

Able to stop using for 7-10 days
Mandated by court or employer
People with alcohol problems
Motivated to eliminate all opioids now
Re-entering from prison or

Nausea or vomiting
Diarrhea
Stomach pain
Decreased appetite
Dry mouth
Headache
Difficulty falling asleep or staying asleep
Diziness
Tiredness
Anxiety
Joint pain or stiffness
Muscle cramps
Weakness
Tenderness, redness, bruising, or itching at the injection site
Constipation
Irritability
Tearfullness
Increased or decreased energy
Rash

Common forms

*Long-acting injection or pill

How do I take it?

Qualified medical professionals can prescribe the tablets or give injections
Tablets are taken daily; long-acting injections are given monthly
Outpatient programs may offer injectable naltrexone

Cost

*Cost varies depending on state, insurance, and other factors. Talk to provider about payment options.

Pregnancy and breastfeeding

*Not recommended; no research on safety of use during pregnancy or breastfeeding

HIV

*Safe to use with HIV medications; low potential for HIV drug interactions

Hepatitis

*Liver damage is possible at very high doses. Most studies report no liver damage at recommended doses. Work closely with your doctor before starting.

Chronic pain

May block effects of opioid medications taken for pain. Can cause withdrawal in people physically dependent on opioid pain medication, unless they stop all opioids 7-10 days before taking it.
Non-opioid pain medication safe with naltrexone at all times. Talk with your doctor about naltrexone and pain.

When can I start?

*After detox or 7-10 days after last use

How long do I take it?

Long-acting injectable form stays in effect for 30 days
The length of treatment should be individualized and determined in consultation with your doctor.
Most studies have been over a 5 month period or longer
Approved for treating alcohol dependency

What happens if I stop?

A person who interrupts treatment with naltrexone and uses opioids sufficiently to become physically dependent again can experience withdrawal when naltrexone is re-introduced.
High risk of overdose if opioid use is resumed - due to lowered tolerance.

What if I use opioid drugs on this medication?

May block effects of opioids
Taking large amounts to override blocking effect has resulted in fatalities
Naltrexone blocks the effects of an opioid and attempts to override the blocking can result in an opioid overdose.

Is It Safe?

Yes. All forms of MAT listed above have been approved by the Federal Drug Administration. Information about side effects:

The Facts about Buprenorphine for Treatment of Opioid Addiction

Vivitrol Information

Methadone: Uses, Side Effects

Does It Work?

"Medication-assisted treatment saves lives while increasing the chances a person will remain in treatment and learn the skills and build the networks necessary for long-term recovery. " Michael Botticelli, Director, National Drug Control Policy

For most people, the use of medications combined with psychosocial treatment is superior to drug or psychosocial treatment on its own. For example, research shows that MAT significantly increases a patient's adherence to treatment and reduces illicit opioid use compared with nondrug approaches. By reducing risk behaviors such as injection of illicit drugs, it also decreases transmission of infectious diseases such as HIV and hepatitis C. There are decades of research concluding MAT is more effective than most other forms of treatment, especially in the case of opioids. For more information and the latest scholarly research, visit our MAT Resources Page.

Where is it available near me?

Call the Illinois Opioid Helpline to find help in your area.