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Treatment
What Is Medication-Assisted Treatment (MAT)? A Plain-English Guide
MAT combines medication with counseling to treat opioid addiction. Here's how it works, what medications are used, and why it's effective.
Medication-assisted treatment — or MAT — is one of the most effective ways to treat opioid addiction. But a lot of people don’t understand what it is or how it works.
This guide explains MAT in plain language.
What is MAT?
MAT stands for medication-assisted treatment. It’s a combination of:
- Medication (like Suboxone or Vivitrol) that reduces cravings and withdrawal
- Counseling to address the underlying reasons for use
- Support to help you rebuild your life
MAT isn’t just taking a pill. It’s a comprehensive treatment approach.
What medications are used in MAT?
There are three main medications approved for treating opioid use disorder:
Suboxone (buprenorphine/naloxone)
- Reduces cravings and withdrawal symptoms
- Taken as a film that dissolves under your tongue
- Taken daily
- Blocks the effects of other opioids
- Lower risk of overdose than methadone
Vivitrol (naltrexone)
- Blocks the effects of opioids
- Given as a monthly injection
- You must be fully detoxed before starting (7-10 days off opioids)
- No risk of misuse because it’s not an opioid
Methadone
- Reduces cravings and withdrawal
- Taken daily at a methadone clinic
- Highly regulated
- Must go to the clinic every day (at least initially)
Southern Highlands offers Suboxone and Vivitrol. They don’t offer methadone.
How does Suboxone work?
Suboxone contains two medications:
Buprenorphine — a partial opioid agonist. It activates opioid receptors in your brain just enough to reduce cravings and withdrawal, but not enough to get you high.
Naloxone — an opioid blocker. It’s included to prevent misuse. If you try to inject Suboxone, the naloxone kicks in and causes withdrawal.
When taken as prescribed (under the tongue), Suboxone helps you feel normal without the highs and lows of opioid use.
How does Vivitrol work?
Vivitrol is an opioid blocker. It sits on your opioid receptors and blocks other opioids from attaching.
If you use opioids while on Vivitrol, you won’t feel anything. This removes the reward, which helps break the cycle of use.
Because Vivitrol is a monthly injection, you don’t have to remember to take a pill every day.
Is MAT just replacing one drug with another?
This is the most common misconception about MAT.
No, MAT is not replacing one drug with another. Here’s why:
Addiction is characterized by:
- Uncontrolled use
- Cravings
- Continued use despite harm
- Withdrawal when you stop
MAT medications:
- Are taken as prescribed
- Reduce cravings (don’t create them)
- Allow you to function normally
- Don’t cause impairment
MAT stabilizes your brain chemistry so you can focus on recovery instead of constantly fighting cravings and withdrawal.
Do you have to be on MAT forever?
Not necessarily. Some people stay on MAT long-term. Some taper off after a year or two. It depends on your situation.
There’s no set timeline. The goal is stability and recovery, not rushing to get off medication.
What does MAT treatment look like?
First appointment:
- Assessment to determine if MAT is right for you
- Medical exam
- Discussion of which medication makes sense
- For Suboxone: you’ll start the medication that day or soon after
- For Vivitrol: you’ll need to detox first, then get the injection
Ongoing treatment:
- Regular appointments with a doctor or nurse practitioner
- Counseling (individual or group)
- Urine drug screens to monitor progress
- Medication refills
Frequency:
- Weekly or bi-weekly at first
- Monthly once you’re stable
Does MAT work?
Yes. Research shows MAT is the most effective treatment for opioid use disorder.
People on MAT are:
- More likely to stay in treatment
- Less likely to overdose
- Less likely to use illicit opioids
- More likely to maintain employment
- More likely to rebuild relationships
MAT saves lives.
What about counseling?
Medication alone isn’t enough. Counseling is a required part of MAT.
Counseling helps you:
- Understand triggers
- Develop coping skills
- Address underlying issues (trauma, mental health, relationships)
- Build a support system
- Plan for the future
Some programs offer individual counseling. Some offer group counseling. Most offer both.
What if you relapse while on MAT?
Relapse is part of recovery for a lot of people. It doesn’t mean MAT failed. It means you need more support.
If you relapse:
- Tell your counselor or doctor
- Don’t stop your medication
- Figure out what triggered the relapse
- Adjust your treatment plan
MAT programs expect relapse and work with you through it.
The stigma problem
There’s a lot of stigma around MAT. People say things like:
“You’re not really sober if you’re on Suboxone."
"You’re just trading one addiction for another."
"Real recovery means being completely drug-free.”
None of that is true.
MAT is evidence-based treatment. It’s recommended by every major medical organization. And it works.
What if you’re pregnant?
MAT is safe during pregnancy. In fact, it’s recommended.
Untreated opioid use during pregnancy is dangerous for both you and the baby. MAT stabilizes you and reduces risks.
Suboxone is the preferred medication during pregnancy. Your doctor will work with you to find the right dose.
What about cost?
If you have Medicaid, MAT is covered. Suboxone and Vivitrol are both covered with little to no copay.
If you don’t have insurance, community mental health centers offer sliding scale fees.
Frequently Asked Questions
Can you get high on Suboxone?
Suboxone has a ceiling effect. Taking more doesn’t make you feel higher. It just reduces cravings and withdrawal.
Will Suboxone show up on a drug test?
Standard drug tests don’t test for buprenorphine (Suboxone). But some tests do. If you’re in a MAT program, your provider knows you’re taking it.
Can you drink alcohol while on MAT?
You shouldn’t. Mixing Suboxone or Vivitrol with alcohol can be dangerous. Your counselor will talk to you about this.
How long does it take for Suboxone to work?
You’ll feel relief from withdrawal within 30-60 minutes of your first dose.
Can you work while on MAT?
Yes. MAT doesn’t impair you. A lot of people on MAT work full-time.
If you’re interested in MAT in Southern West Virginia, you can call Southern Highlands. They offer Suboxone and Vivitrol programs. Suboxone: (304) 425-9541 ext. 1277. Vivitrol: (304) 425-9541 ext. 1525.