How MAT Works: The Drugs That Help Save Lives From Opioid Addiction

Yhaimar Barile
Jun 24
6 min read

**Key drugs in Medication-Assisted Treatment (MAT) that support recovery from opioid addiction**

The opioid crisis continues to hurt communities nationwide. In the U.S., more than 80,000 people die from opioid overdoses each year, and many more struggle with opioid use disorder (OUD) (CDC). According to the CDC, only a fraction of the sick receive evidence-based care. Despite the need for effective treatments, stigma surround one of the most effective solutions: Medication-Assisted Treatment (MAT).

This article clarifies MAT and explains how three FDA-approved medications: methadone, buprenorphine, and naltrexone, support recovery. Backed by decades of research, MAT is a method to save lives and offer a path to long-term health.

What Is Medication-Assisted Treatment (MAT)?

Medication-Assisted Treatment is an evidence-based way to treat opioid use disorder. It combines FDA-approved medications with behavioral therapies. Unlike abstinence-only methods, MAT addresses both the physical and psychological parts of addiction. This approach improves long-term recovery outcomes and helps individuals regain control of their lives.

Top health organizations, like the Center for Disease Control and Prevention (CDC), the World Health Organization (WHO), and the Substance Abuse and Mental Health Service Administration (SAMHSA) recognize Medication-Assisted Treatments as an effective way to treat Opioid Use Disorder. MAT has become a cornerstone of modern addiction medicine.

How Does MAT Work?

The medications used in MAT help reduce opioid related deaths, prevent relapse and support recovery. This section covers three government-approved medications: methadone, buprenorphine, and naltrexone. We'll look at how each works, how they are given, and their important role in saving lives from opioid addiction.

1.Methadone

For decades, healthcare providers have used methadone to help individuals overcome opioid addiction (more about the origins of methadone treatment). It's crucial to note that methadone, itself is a synthetic opioid. However, it works differently than illicit drugs when in the structured setting of MAT.

How Does Methadone Work

Methadone works by attaching to opioid receptors in the brain, like other opioids such as heroin. However, unlike street opioids that create a rapid high, methadone's effects come slowly and last longer. The prolonged effect helps to reduce cravings and maintains a steady opioid level in the body. Methadone also blocks opioid receptors. This stops other opioids from working, prevents the high, help people maintain stability, and resist further opioid use.

How is Methadone Administered

Healthcare providers give methadone in liquid, tablet, or powder at certified opioid treatment programs. These clinics supervise dosing to ensure patient safety and help with medication adherence. Rehabilitation usually lasts at least 12 months, but longer-term programs can benefit patients. Participants can start a methadone regimen without detoxification or needing to stop using opioids first.

How Does Methadone Save Lives

Methadone saved lives by tackling the main issues of opioid addiction. It stabilizes users with a medically supervised dose of an opioid, reducing cravings, and easing painful withdrawal symptoms. Stability is key. It helps people escape the cycle of seeking and using illicit opioids. This also lowers the risk of overdose from harmful drugs like heroin or fentanyl.

Treatment programs often offer vital wrap-around services. Counseling and support groups provide individuals with the tools they need for long-term recovery. Together, these methods tackle the physical side of addiction and its psychological roots. This leads to lasting change and lowers the risk of fatal overdoses.

2. Buprenorphine

Buprenorphine is an opioid medication similar to methadone. However, it is a partial opioid agonist. In contrast, methadone and illicit opioids like heroin and fentanyl are full opioid agonists. This difference makes buprenorphine a safer and more effective treatment option for many.

How Does Buprenorphine Work

Buprenorphine binds to opioid receptors in the brain, partially activating them. This reduces cravings and withdrawal symptoms without causing the intense euphoria linked to full opioid agonists. Its strong affinity for these receptors lets buprenorphine block other opioids from binding. This helps prevent relapse and the desired high.

Buprenorphine also has a "ceiling effect." Increasing the dose won't enhance its effects past a certain point. This lowers the risk of respiratory depression and overdose. While both methadone and buprenorphine reduce cravings and intoxication during treatment, they work in different ways.

How is Buprenorphine Administered

Healthcare providers prescribe buprenorphine in different forms, like sublingual tablets, long-acting injections, and implants. This variety helps create treatment plans to fit each person. Patients must be in a state of mild-to-moderate withdrawal before starting buprenorphine. This prevents precipitated withdrawal. Often, patients must wait 12–24 hours after the last opioid use.

How Does Buprenorphine Save Lives

Buprenorphine saves lives by lowering the risk of overdose and improving access to treatments. Its unique features reduce the chance of respiratory depression, a major cause of opioid-related deaths. Unlike methadone, which requires daily visits to clinics, doctors can prescribe buprenorphine in primary care settings. This allows patients to take it at home. Such flexibility helps more people begin treatment sooner and stay in recovery. By blocking other opioids, buprenorphine prevents relapse. It offers a safer and more convenient option for many facing opioid use disorder.

3. Naltrexone

Naltrexone is a medication doctors prescribe for the long-term treatment of opioid and alcohol use. Naltrexone is not an opioid. Instead, it is a opioid antagonists. Antagonists block the effects of opioids at their receptors in the brain. This differs from medications like methadone and buprenorphine, which are opioid agonists that activate opioid receptors. Since naltrexone blocks opioid receptors rather than activating them, It does not produce a high. It also does not lead to physical dependence or cause withdrawal symptoms when someone stops taking it.

Naltrexone and naloxone can be easily confused because their names are similar, but they have different purposes (see explanation). Naloxone (brand name Narcan) is a fast-acting opioid antagonist. It helps reverse opioid overdoses during emergencies. Think of it as a rescue medication. It quickly displaces opioids from the brain's opioid receptors. Doctors prescribe naloxone only for acute opioid overdose. In contrast, naltrexone helps with ongoing addiction treatment after someone completes detoxification,

How does Naltrexone Work

Naltrexone blocks opioid receptors in the brain. When someone uses opioids or alcohol, they can't activate these receptors. This prevents the pleasurable effects that leads to addiction. As a result, cravings decrease, and relapse risk lowers. Since naltrexone doesn't mimic opioids or create opioid-like effects, it has no risk of misuse or dependence.

How is Naltrexone Administered

Healthcare providers prescribe naltrexone as daily oral tablets or monthly extended-release injections. Providers administer the injection in a medical setting. Patients take tablets at home under supervision. Before starting naltrexone, patients must complete detoxification. They must also stay opioid-free for 7–10 days to prevent withdrawal from receptor blockade.

How Does Naltrexone Save Lives

Naltrexone can save lives for people with opioid use disorder. It helps break addiction cycles and lowers relapse risk. If someone on naltrexone relapses and uses opioids, they are less likely to overdose. This is because naltrexone blunts the opioid's effects. Its low abuse potential makes naltrexone safe, especially for those with past addiction history. When paired with counseling and supports, naltrexone helps individuals to rebuild their lives and achieve lasting recovery.

Conclusion

Decades of research shows that Medication Assisted Drugs like methadone, buprenorphine, and naltrexone, are vital for opioid-related mortality. Studies show that individuals who receive MAT are less likely to die from an overdose than those who try abstinence-only recovery. These medication stabilize brain chemistry, reducing cravings, and help individuals regain control of their lives and maintain long-term recovery.

As the opioid crisis keeps taking lives, increasing access to MAT medications is crucial. If you or someone you know is struggling with opioid use disorder, seeking evidence-based treatment with MAT could be the key to recovery. Call the SAMHSA National Helpline at 1-800-662-HELP for confidential support and treatment resources.