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Medication-Assisted Treatment (MAT) at Sandstone Care


Medically reviewed by Dr. Jennifer Montague

Medication-Assisted Treatment (MAT) is a medical practice that helps young adults remain substance free when entering treatment and throughout their recovery. MAT involves the use of prescription drugs designed to help ease the withdrawal process, maintain sobriety, and prevent relapse in recovery. Clients that struggle with alcoholism or opioid use disorder are primarily the recipients of Medication-Assisted Treatment. MAT works best when coupled with treatment programs like those offered at Sandstone Care, where a focus is put on co-occurring mental disorders in addition to drug or opioid addiction.

Medication-Assisted Detox (MAD) vs. Medication-Assisted Treatment (MAT)

Many treatment centers claim to offer Medication-Assisted Treatment to clients, but only provide medication assisted detox or take a one size fits all approach to prescribing MAT. Sandstone Care offers both Medication-Assisted Treatment and Medication-Assisted Detox to clients in need.

Known well in the medical community, MAT is a long-term maintenance therapy, coupled with intensive psychiatric treatment. While MAT is only utilized for clients with opioid or alcohol use disorder, a level of Medication-Assisted Detox is given to everyone with a dependence that enters treatment. Without the medication prescribed in MAD, opioid users that stop taking them can go through painful, flu-like withdrawal symptoms. Medication-Assisted Treatment, on the other hand, is utilized throughout the continuum of care at Sandstone Care, supporting a client's journey to recovery. See the section below called "Medication-Assisted Treatment (MAT) at Sandstone Care" to learn how each level of care administers and monitors MAT.

What is the Goal of MAT?

At Sandstone Care, the goal of Medication-Assisted Treatment is to couple psychiatric care with a highly structured medication regimen to support healing from the inside out. Medications used in MAT work to control addiction within the limbic system, while other aspects of therapy support the rest of the body and mind.

Dr. Jennifer Montague, Senior Medical Director at Sandstone Care commented, “MAT is used in rehabilitation to give the other disciplines the time to work. We know that addiction is a complicated disease that involves the biological, psychological, social, and socioeconomic aspects of life. There are a lot of barriers to why someone might not be able to get sober just beyond the limbic system, and a lot of pieces that must come together for someone to gain recovery. We look at MAT as stabilizing the limbic system while we work on coping skills, work through trauma, and get you hooked up with resources in the community.”

Medication-Assisted Treatment (MAT) for Opioid Use Disorder

According to The Diagnostic and Statistical Manual of Mental Disorders, opioid use disorder is defined as a problematic pattern of opioid use leading to problems or distress, with at least two of the following occurring within a 12-month period:

  • Taking larger amounts or taking drugs over a longer period than intended.
  • Persistent desire or unsuccessful efforts to cut down or control opioid use.
  • Spending a great deal of time obtaining or using the opioid or recovering from its effects.
  • Craving, or a strong desire or urge to use opioids
  • Problems fulfilling obligations at work, school, or home.
  • Continued opioid use despite experiencing recurring social or interpersonal problems.
  • Giving up or reducing activities because of opioid use.
  • Using opioids in physically hazardous situations.
  • Continued opioid use despite ongoing physical or psychological problem connected to opioids.
  • Tolerance (i.e., need for increased amounts with continued use of the same amount)
  • Experiencing withdrawal or taking opioids (or a related substance) to avoid withdrawal symptoms.

Sandstone Care prescribes two FDA-approved drugs to treat opioid use disorder: buprenorphine (Suboxone and Subutex are common brands) and naltrexone (Vivitrol and Revia are common brands). These treatments have been demonstrated to be safe and effective in combination with counseling and psychosocial support. These medications either reduce the cravings or block the ability of the drug to create the “high” in the person’s brain.

Medication-Assisted Treatment (MAT) for Alcohol Use Disorder

According to the CDC, alcohol use disorder is defined by periods of binge and heavy drinking along with physical dependence on alcohol, cravings, drinking more to achieve the desired effect, and experiencing withdrawal symptoms when you do not consume alcohol.

  • Drastic changes in academic performance
  • Loss of interest in previously-enjoyed activities
  • Decreased personal hygiene
  • Sudden, inexplicable need for money
  • Alcohol use in spite of consequences
  • Smell of alcohol on breath or clothes
  • Flushed, reddened skin
  • Slurred or garbled speech
  • Coordination problems
  • Changes in sleep pattern
  • Difficulty concentrating
  • Mood swings
  • Use of alcohol to numb extreme emotions

Sandstone Care prescribes two FDA-approved drugs to treat alcohol use disorder: naltrexone (Vivitrol and Revia are common brands) and acamprosate (Campral is a common brand). These treatments have been demonstrated to be safe and effective in combination with counseling and psychosocial support.

Who Might Be a Good Fit for Medication-Assisted Treatment (MAT)?

  • History of overdose, intentional or unintentional
  • History of medical complications (infections like septic joints, endocarditis, hepatitis)
  • History of multiple relapses
  • Single history of severe/life threatening relapse
  • Significant cravings
  • Drug recall euphoria/obsessive thinking
  • History of high risk behaviors in relapse
  • Unstable living environment
  • Continued exposure to use after discharge
  • Inadequate aftercare plan

"Weird, Freaky Brain Science" Behind MAT

To understand what prescribed medications are used for in Medication-Assisted Treatment, it is important to understand how alcohol and opioids affect the brain. According to Dr. Montague, addiction causes the limbic system to view the substance as a priority for your body just as much as your next breath. Your body begins to see your next drug or drink as not only a want, but a life-saving need. Simply put, we cannot erase the connection your brain made that caused the need to use drugs or alcohol. We can only treat the body with Medication-Assisted Treatment, while other psychiatric treatments take place through therapy.

Medication-Assisted Treatment (MAT) at Sandstone Care

Throughout the recovery journey, individuals experience cravings and other withdrawal symptoms that can often lead to relapse. Sandstone Care utilizes MAT to ease the recovery transition and support each client’s specific needs. Our program combines medication, therapy, and other treatments. To begin the process, clients go through a clinical assessment to determine if MAT is the right choice as part of their long-term recovery. Medications are prescribed specific to the client’s dependency, and use is highly monitored by medical professionals.

While the medication prescribed through MAT can solve physical problems for a client during rehabilitation and recovery, it cannot always solve the behavioral and mental issues found at the root of addiction. It is important to remember that MAT does not work alone – clients receiving MAT should commit to all aspects of treatment in order to overcome addiction. Therapy is key to building a new set of coping skills to help combat addiction physically and mentally. That is why Sandstone Care offers Medication-Assisted Treatment to clients at any of our program locations and treatment levels. See below to learn how each level of Sandstone Care’s Continuum of Care allows for MAT.

Detox

As discussed above, medical detox is necessary for people struggling with dependence on certain substances. Sandstone Care medical staff takes time to assess each client and identify the best course of action while in detox. Some medications prescribed can help with withdrawal symptoms, while others help prevent relapse after detox is complete.

Residential Treatment

Members of our residential treatment program are highly monitored and cared for by medical professionals. Our personalized services identify a safe medication and dosage for each client, and increase or decrease as needed. Each client in residential treatment will check in with a medical provider twice a week, and with a registered nurse three times daily to talk through symptoms and withdrawal management. A huge focus is put on physical wellbeing at this point in the treatment process, and our medical team is ready to support each client individually.

Day Treatment (PHP)

Although outpatient services include a reduced number of hours in a treatment center, our Partial Hospitalization Program (PHP) staff consistently support each client throughout their recovery journey. Clients in PHP meet with their medical provider once a week to discuss how things are going with their medication dosage and treatment. At this point in treatment, clients work with their therapist to focus on the other components of addiction. Co-occuring disorders such as anxiety or depression begin to be discussed with clients, and plans of action are made to address them.

Intensive Outpatient Treatment (IOP)

The Intensive Outpatient Treatment (IOP) program at Sandstone Care is looked at as a maintenance phase when it comes to MAT. Clients meet with a medical provider either bi-weekly or monthly to discuss any adjustments that need to be made to medication dosage.

Sober Living

Within our Sober Living facilities, housing managers have direct communication with your treatment program’s physician and can assist you in making sure your medical needs are addressed. Your entire team, including your housing managers, therapists, and medical team, will meet weekly to discuss your progress in the program. Housing managers write individual client reports twice a week to clinical and medical staff. We will help keep you accountable through urine drug screen and breathalyzer screens and these will be communicated directly to your clinical-medical team.

How Sandstone Care’s Clinical Framework Supports MAT

In order for someone to truly heal from the inside out, they need a good therapist and a clinical staff. According to Dr. Montague, “To rebuild your life, you will need a supportive cohort of friends and family, along with really good trauma care and coping mechanisms. The clinical healing tools gained from treatment come through hard work and emotional support, which is exactly what Sandstone Care offers to those ready to work hard for recovery.”

The unique clinical framework at Sandstone Care addresses each aspect of life Dr. Montague mentions as keys for recovery. There are five pillars of success for clients within the clinical framework or CLICC:

Commitment to Sustainable Change

To achieve a new sustainable lifestyle, individuals and families must accept that meaningful change is vital to recovery. We believe the development of values and beliefs is the first step in providing the foundation for this change. To find a sustainable change, the individual must work with their family members and our clinical team to develop this set of values.

Life Skills Development

Our teens and twenties are years filled with opportunities to develop, but they are also a time filled with confusion and new challenges. Unfortunately, many people turn to substance use to cope with these new challenges and everyday stress. At Sandstone Care, individuals will learn coping skills and they’ll continue the process of defining who they are so they can tackle life’s challenges with confidence.

Clinicians call this experience identity formation. In academia, this process is called choosing your major. We recognize that when clients see their schoolwork and career choices as expressions of who they are, they flourish. Our goal is to help you flourish.

Integrity to Values

Individuals can discover and restore the values that their families hold dear while growing a sense of personal responsibility. With a stronger sense of integrity, clients can cultivate their own values, beliefs, and passions that will continue to keep them strong in the face of temptation.

Connection to Others

Through group therapy, clients can develop healthy and authentic relationships that aren’t based on a desire for substance use. Group therapy is also an opportunity to re-establish relationships with family members and other loved ones. Establishing stable relationships in a safe community can positively reinforce the individual’s commitment to change.

Community Support System

The ultimate goal of the program is to create a new, sustainable, joyful and meaningful way of life. Sandstone Care has dedicated resources and clinical staff to help our clients identify classes, jobs, sports, and other activities that help individuals connect to vibrant and inspiring communities. These new communities are often the key to a new, healthy lifestyle that supports long-term recovery.

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