Medication-assisted treatment (MAT) is a form of drug addiction treatment that uses medications that have been approved by the U.S. Food and Drug Administration (FDA) in conjunction with counseling and behavioral therapies. The goal of MAT is to provide a holistic approach to treatment to give individuals the greatest chances of achieving and maintaining sobriety.
MAT was primarily developed for the treatment of opioid and alcohol use disorders as well as for people who want to quit smoking. FDA-approved medications are used to replace the substance of misuse. The medications stabilize brain chemistry and physical body functions, prevent the user from experiencing a high anymore and reduce cravings for the drug.
Medications are not the only component, however, of MAT. Federal law requires that MAT programs provide therapy and counseling services to patients alongside the medications being administered. By providing a well-rounded set of services, patients are most likely to achieve full recovery, which is the end goal of MAT.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), MAT has been proven to:
MAT provides individualized treatment plans for everyone who participates in it. Medications are prescribed based on the individual’s specific history of drug use and what is needed to reduce drug use now. Behavioral therapies are also tailored to meet the needs of the individual. MAT provides a person-centered approach to treatment that is continually adapted for the treatment of more substance use disorders.
Cocaine is a popularly misused substance that leads to stimulant use disorder in many people. SAMSHA estimates that in 2014 more than 900,000 people over age 12 had a cocaine-related stimulant use disorder. Symptoms of stimulant use disorder include:
Currently, there are no FDA-approved medications to help with the treatment of cocaine addiction. Researchers have recognized for many years, however, the important role that such medications could play in treating cocaine addictions.
Similar to MAT for other substances, medications could help those trying to stop cocaine use by stabilizing their systems and reducing intense cravings that lead many people to relapse.
Since the mid-2000s, researchers have observed the effectiveness of disulfiram, a medication used to treat alcoholism, in the treatment of cocaine dependence. Researchers have also made progress on a vaccine that could be given to people in recovery from cocaine addiction. Such a vaccine would produce antibodies that help to prevent relapse.
More recently, the National Institute on Drug Abuse (NIDA) reported progress researchers have made on the development of disulfiram and the vaccine for cocaine addiction. They have also found that disulfiram contributes to a decrease in cocaine use, but they are not sure exactly why. In addition, disulfiram is not effective at reducing cocaine use in all users as it is with alcohol. Researchers have also been investigating neurotransmitters other than dopamine that could be targeted to treat the addiction.
Besides medications like disulfiram, researchers continue to work on the vaccine that could reduce the risk of relapse. They believe the vaccine stimulates the immune system in such a way that antibodies bind to cocaine and prevent it from entering the brain. The vaccine must be further developed, however, as less than 40 percent of people who received the vaccine built up enough antibodies for it to be effective, and the antibodies only lasted for two months.
While there are not any approved MATs for cocaine addiction yet, these studies show that progress is being made in that direction. It is clear to researchers that medications can be effectively and safely administered to treat cocaine addiction. Further research must be conducted, however, to determine which medications will be effective for most people and for the longest period of time.
Since MAT is not yet an FDA-approved option for someone looking to treat their cocaine addiction, there are other options. One of the most effective treatment methods for stimulant use disorders is the Matrix Model. The Matrix Model was designed in the 1980s specifically to treat the cocaine epidemic at the time. It is a highly structured program that consists of the following elements:
If the Matrix Model is not used by an accessible treatment center, you still have other treatment options that are proven to be effective for treating cocaine addiction. Treatment centers across the country are highly experienced in working with people who have cocaine addiction.
According to NIDA, almost 6 percent of admissions to drug abuse treatment programs in 2013 were for cocaine use disorders. Treatment programs often use a combination of pharmacological treatments and behavioral interventions to provide comprehensive addiction treatment. For cocaine addiction, treatment can take place in outpatient or inpatient settings depending on the individual’s needs.
Behavioral therapies that are effective for helping people beat their cocaine addiction include the following:
This is not an exhaustive list of effective behavioral therapies for treating drug addiction. Additionally, programs are likely to use a mix of multiple approaches to therapy. By having many different therapeutic approaches available, therapists can use whatever the client responds to the best. Through an honest, holistic, and collaborative evaluation of the individual’s addiction, they are the most likely achieve and maintain sobriety for the long term.
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Some addiction treatment professionals criticize the use of MAT for being a replacement therapy, where one drug is just being replaced by the other. Critics of MAT are wary of using drugs to treat drug addiction, as it feels counterintuitive. They prefer to help individuals through the detox process and see that all substances are out of the system once the detox phase is over. In MAT, people remain dependent on medications to achieve their sobriety. Medications taken with MAT may be prescribed for weeks or months, depending on the individual.
Supporters of MAT, however, recognize the health benefits people can achieve from participating in the treatment. They believe that prescribing safer and less-potent stimulants is an effective way to treat an addiction to cocaine. Through MAT, users can be safely tapered off cocaine without the risk of experiencing severe withdrawal symptoms that can inhibit recovery. People participating in MAT typically do not have to go through a challenging withdrawal process, as the body is given a significant amount of time to adjust to cocaine, or whatever the addictive substance is, leaving the body. Still, more research is needed to gain a better understanding of correct dosages and which stimulants are best for treating cocaine addiction.
The scope of addictions that MAT is designed to treat is constantly growing. Researchers are continuously working to expand the range of substance use disorders that can be treated through MAT. As of yet, it has only been thoroughly developed for the treatment of opioid use disorder and alcohol use disorder as well as for people who would like to quit smoking.
MAT is a good form of treatment for people who stand to face significant and dangerous withdrawal symptoms, such as seizures that can occur during alcohol withdrawal. A growing body of research supports MAT as an evidenced-based approach to treatment. Criticism about MAT use may be preventing more people from taking advantage of it, however. Once medications are clearly identified that help to treat cocaine addiction, MAT could be a highly effective form of treatment.
(May 2016). Cocaine. National Institute on Drug Abuse. Retrieved November 2018 from https://www.drugabuse.gov/publications/research-reports/cocaine/what-treatments-are-effective-cocaine-abusers
(September 2015). MAT for Methamphetamine or Cocaine Addiction: The Case for Rx Stimulants. Alcoholism and Drug Abuse Weekly. Retrieved October 2018 from https://onlinelibrary.wiley.com/doi/pdf/10.1002/adaw.30320
(February 2018). Medication-Assisted Treatment (MAT). Substance Abuse and Mental Health Services Administration. Retrieved November 2018 from https://www.samhsa.gov/medication-assisted-treatment
(December 2005). New Medications for the Treatment of Cocaine Addiction. Psychiatry. Retrieved November 2018 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2994240/
The Matrix Model of Intensive Outpatient Treatment. The Matrix Institute on Addictions. Retrieved November 2018 from https://www.matrixinstitute.org/wp-content/uploads/2014/03/Matrix_Model-Description-and-Outcomes-Research.pdf