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Five medications, approved by the FDA, have been developed to treat alcohol and opioid use disorders. Currently, no approved medications are available to treat marijuana, amphetamine, or cocaine use disorders. Table 4.4. lists these medications. Like all other FDA-approved medications, those listed in Table 4.4 demonstrate “well-supported” experimental evidence of safety and effectiveness for improving outcomes for individuals with alcohol and opioid use disorders. At the same time, all of these medications have side effects; two (methadone and buprenorphine) have the potential to be misused, and methadone (and to a lesser extent buprenorphine) has the potential for overdose. For these reasons, only appropriately trained health care professionals should decide whether medication is needed as part of treatment, how the medication is provided in the context of other clinical services, and under what conditions the medication should be withdrawn or terminated. The combination of behavioral interventions and medications to treat substance use disorders is commonly referred to as MAT. Smith (2015) indicates that MAT is a highly effective treatment option for individuals with alcohol and opioid use disorders. Studies have repeatedly demonstrated the efficacy of MAT at reducing illicit drug use and overdose deaths, improving retention in treatment, and reducing HIV transmission. Some medications used to treat opioid use disorders can be used to manage withdrawal and as maintenance treatment to reduce craving, lessen withdrawal symptoms, and maintain recovery. These medications are used to help a patient function comfortably without illicit opioids or alcohol while balance is gradually restored to the brain circuits that have been altered by prolonged substance use.
A question frequently asked non-medically trained mental health providers is, “does this mean most of these treatments just substitute one opiate for another?” Citing at least one research article, please address the following in your response to this question:
How strong is the body of evidence behind Medication Assisted Treatment?
Does psychotherapy really need to be incorporated in order for MAT to work effectively?
What are the gaps in research?
Table 4.4, Pharmacotherapies Used to Treat Alcohol and Opioid Use Disorders – Facing Addiction in America – NCBI Bookshelf.pdf