First, I am not a doctor, or a trained counselor, or an addiction treatment professional of any kind. I am not even an addict. I am simply a Mother. I have two beautiful sons, and my oldest, now 25 years old, is a recovering addict who thankfully has been drug free for almost four years.
He asked me to write about Medication Assisted Treatment, which is hard. I don’t have the professional background to give you an educated medical or scientific discussion. So, I am not going to cite research or statistics, or advocate for one side or another on this very difficult and emotion-filled issue.
Instead, I am simply going to provide a basic outline of the arguments on both sides, and a few thoughts, based only on my limited experience.
What Is Medication Assisted Treatment?
Medication Assisted Treatment for addicts, sometimes called MAT, consists of several different medications, the most common of which (for opioid use) are Suboxone and Methadone.
These are often administered to the addict for a period of days during the detox period to allow the addict to safely withdraw from opioids. However many addicts continue to use these medications on a much longer-term basis, and some addicts never are able to stop using them completely.
The Pros of MAT
The pros: MAT allows the addict to regain a more balanced state of mind, relatively free of the drug-related highs and lows, and helps the person to focus on recovery. In the short term it helps the addict to navigate the medical detox process safely.
In addition, in concert with traditional treatment methods, including:
- Counseling
- 12-step programs
- Meditation
- Lifestyle changes, etc.
MAT can improve the chances of long-term success, particularly in addicts who have repeatedly relapsed.
The Cons of MAT
The cons: MAT has many potential side effects, including anxiety, stomach issues, and sleep disorders. Much more serious, overdose is possible, particularly with methadone, but also on other forms of MAT. Addicts who decide to abuse opioids, or other drugs or alcohol while on MAT can overdose and die, and sadly many have done so.
Addicts also sometimes sell their MAT medications to buy illegal drugs. Also, MAT can become a long-term treatment, or sometimes a permanent need. Some addicts cannot successfully taper from MAT use, and so never stop using the MAT medications.
Critics of MAT argue that it is simply a substitution of one addictive substance for another, and therefore antithetical to the very idea of true recovery. Lastly, MAT is unlikely to work unless used in conjunction with the traditional treatment methods described above.
MAT Isn’t a One-Size-Fits-All Answer
So as a parent, my take is this: there does not seem to be a one-size-fits-all answer here. My son was given the above-mentioned MAT medication Suboxone, along with Ativan, Flexeril and Robaxin, for a matter of days, and only during his detox periods.
After that he spent time, without MAT, in inpatient rehabs, IOPs, and sober living facilities. His recovery has been far from a smooth ride, but he has been successfully clean for almost four years now, and God willing, will continue to remain drug free.
Start Without MAT, and then See What Happens
I am deeply grateful that he does not have to deal with the continued use of, or attempts to taper off from, any MAT medications, and it seems to me that long-term recovery without MAT is the best place to start.
Recovery is enough of a challenge without long-term use of MAT medications. However, for those addicts who have repeatedly relapsed, despite efforts at MAT-free recovery, MAT appears to be a better, sounder and safer option than the frightening alternatives of repeated relapse and addiction to illegal drugs.
A Good Addiction Treatment Team Matters
If my son had suffered numerous relapses, I would hope he would be open to some form of extended MAT treatment, and we would try hard to find a well-trained, reputable addiction treatment team to guide him during the long-term MAT recovery process.
Open Discussion Is Key to Progression
We are all in this together, and we need to encourage and support one another in fighting the horrific disease of addiction. It is critical that we continue to discuss MAT and the many other difficult and controversial addiction-related issues.
Naturally we sometimes will disagree. But lets keep in mind that our ultimate goal is the same for all concerned – long-term, successful treatment and recovery for people who suffer from addiction, and for their family members.
Best wishes to you all,
Laurie Kesaris
Laurel McGinnis
Brie Rodriguez
CORI BAIZA
JOHN GAU
MARK GUDIM
Jeffrey M. Bishop, D.O.
AMANDA MARINELLI, DNP, BBA, AG NP-BC, PMHNP-BC, CARN-AP
I want to thank you for writing this. I am currently on methadone and have been for some time. I found out I was pregnant back in 2009 with my beautiful daughter Layla who is now almost 5 and I had no other choice but to get on methadone. It saved her and my life. I appreciate you writing the pros and cons and not just the cons. A lot of people like to only see the negative. It has kept me clean and changed my life in a HUGE way. The negative side effects are there and I fear I will never get off of methadone but I will try. Thank you and God bless!!
Dear Michele,
Thank you so much for your kind comments. You are an incredibly brave mother to get clean for your beautiful little girl. And you are absolutely right — MAT medications such as methadone are sometimes the best and only solution to addiction, especially in cases like yours.
Many prayers to you and your sweet baby daughter —
Laurie Kesaris
Dear Michele,
Thank you so very much for your kind comments. What an incredibly brave mother you are. You did what you had to in order to keep your beautiful baby girl safe and healthy. I am so happy to hear you are both doing well, and am grateful that with MAT you are here to tell your story.
Love and best wishes to you both,
Laurie Kesaris
Thank you for taking time to write this article. I am a addict in recovery and have been on both sides. I don’t begrudge anyone that needs to be on something I mean really needs it. However for myself I ultimately feel better and have a better quality of life when not on any MAT. I agree if you are on something you need to use the other components such as meetings, counseling, sponsor, step work, etc. to really make it work.
Thank you!
Dear Shelly,
Thank you so much for your kind comments. It is always heart-warming to hear from someone who has benefited from reading one of my articles. Best wishes as you continue in your recovery.
Many prayers,
Laurie Kesaris
Thanks very interesting blog!
I am very happy to see that your center is accepting of MAT. Since recovery is not one size fits all, what works for one may not work for the other. My opinion is whatever works. I have been on MAT for 3 years and I would be dead if I had not chosen this as my mode of recovery. I also attend 12 step meetings and am very active in the recovery community. I know that there are alot of negative responses from those groups regarding MAT – you just have to find the right one. My friends ALL support me in my choice of recovery. One day at a time!!
Dear Kathi,
Thank you so much for writing. How wonderful that with MAT you have been in recovery for three years. I agree completely — MAT can save lives and I am so very happy you are here to tell your story.
Many blessings to you as you continue in your recovery —
Laurie Kesaris
first I am a mom of a heroin addict we are now after 4 years of hell trying yet again to get her clean she is on suboxone it is the toughest fight of my life i have now realized its up to her she has to want it so we support her and are raising her son most of my family has turned their backs on us because of this she has never involved them in her antics so ive learned alot over these years it doesnt matter where you come from it affects everyone and as a nation we are failing our kids there just is not enough rehab or detox centers
I got clean from heroin in March using Subutex. I can barely get out of bed without it though. I have had 2 shots since being clean I don’t know If i could call it a relapse. I made sure I had subutex after to help but I do miss the occassional high. Thats not why im commenting though….I know your not a medical expert but why has it been so hard to stop taking subutex. I know im not addicted to it I go as long as I can without it but my body is so damn weak and lifeless and i have absoultely no energy. i know the 2 shots havent helped but I have been taken the subutex exactly as they gave it to me in rehab. Will I ever get back to my normal self?? Or am I stuck being frail and tired forever. Oh and there have been days i haven’t taken subutex but i just can’t get the energy back. do I just wait longer?? BTW im only 28. sorry this is so long