Medication Assisted Treatment


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Q&A About MAT

Answers from Irakli Mania, MD and Jagdeep Kaur, MD, psychiatrists at Keystone Behavioral Health in Chambersburg, Pa.:

What is MAT and makes it different from other treatment options?

mania_MATDr. Mania: Medication assisted treatment uses FDA-approved medications, for example Methadone and Buprenorphine, in conjunction with psychosocial counseling and support to treat substance use disorders.

The most common misperceptions from our patients is that by prescribing Buprenorphine or Methadone, we are just replacing one addiction with another. That is not true. There is a big difference between being physically dependent on a controlled substance in a controlled setting vs. substance use disorder, which is a brain disease where a primitive part of your brain is dysfunctional to the point where the drug becomes the biggest motivation in your life.

Why is it important that these medications be administered by a certified physician?

Dr. Mania: (Buprenorphine) comes with all the side effects we’re seeing with prescription medications. They need to be monitored. Dosage adjustments are also something that a qualified physician should take care of.

kaur_MATDr. Kaur: People might abuse Buprenorphine. They can take it more than prescribed. They can inject it. To combat that, they have added naloxone to the compound. So if a people tries to inject it, they will go into withdrawal. Knowing how these drugs work is a must for any prescriber.

How do you choose the specific medication for MAT?

Dr. Kaur: You do a complete history, which covers what they are using and how much they are using. We need to assess what is a good fit.

For example, if patients are early in their drug use and have reliable social support, Naltrexone may be a good fit. You need to be clean for seven days to start the Naltrexone. That is the critical time because of the withdrawal symptoms.