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For people who have developed an opioid dependence or addiction, medication-assisted treatment (MAT) – also often called pharmacotherapy, or medication for opioid use disorder (MOUD) – is a very effective way to stop or significantly reduce their opioid use.
There’s lots of help available for people who are dependent on opioids.
The types of help available include getting support, learning how to change your behaviour or taking medications to reduce cravings and prevent withdrawal.
There is no single treatment that is perfect for everybody. Different treatment types suit different people.
A lot of people struggle with opioid dependence and addiction. Seeking treatment is a normal and effective way for them to manage, reduce or stop their opioid use.
Opioid dependence and addiction can be an ongoing (chronic) condition and can require longterm treatment and management.
Different countries have different treatment options and different ways of accessing them. Talk to your doctor about the options that are available to you and the costs, if any, that are involved.
What is medication-assisted treatment (MAT)?
Opioid dependence and addiction can be treated with medication. This is known as medication-assisted treatment (MAT) – also often called pharmacotherapy, or medication for opioid use disorder (MOUD).
When someone with an opioid dependence or addiction begins medication-assisted treatment (MAT), a doctor prescribes them slow-acting opioids that reduce cravings, prevent withdrawal and reduce the risk of overdose.
This will usually be medications called methadone and buprenorphine, but it may include others, such as slow-release oral morphine.
MAT allows people with an opioid dependence or addiction to:
Though it’s not effective for everyone, many people find MAT helps them to break the cycle of opioid dependence and addiction.
With their cravings and withdrawal managed, people on MAT can give more time and attention to other parts of their lives.
Everyone’s goals are different. Once stabilised, a person may wish to taper off (or gradually reduce) MAT or they may be comfortable staying on a maintenance program.
You’re more likely to be successful at reducing your opioid use on MAT than with any other type of treatment. Medication-assisted therapy is the most effective treatment for opioid dependence and addiction, but combining psychosocial treatments with MAT can lead to even better outcomes.
Below are the types of MAT most commonly used to treat opioid dependence or addiction.
Methadone is a slow-acting opioid. It can be used to treat pain but is more commonly used to treat opioid dependence and addiction.
Methadone can be prescribed to people with an opioid dependence or addiction to prevent symptoms of withdrawal and reduce cravings.
People taking methadone will usually take one dose every day.
How is methadone administered?
Methadone, when prescribed for opioid dependence, usually comes as a syrup that the person drinks.
Patients on methadone need to attend a clinic or pharmacy every day to receive their dose.
Some countries allow methadone patients to be given takehome doses to reduce how often they need to attend the clinic. Check with your doctor or clinic about this.
Buprenorphine is also a slow-acting opioid. Like methadone, it can be used to treat pain, but is more commonly used to treat opioid dependence and addiction.
How is buprenorphine administered?
Buprenorphine usually comes as a tablet or film that’s dissolved under the tongue.
Buprenorphine is also available in long-acting doses, either as implants that are put under the skin and last for six months, or as a prolonged-release injection that lasts for either a week or a month. These long-acting doses reduce the need to attend a clinic as often.
Naltrexone is a long-acting, prescription opioid antagonist medication that is sometimes used to treat opioid use disorder, but more often alcohol dependence.
How is naltrexone administered?
Naltrexone can be prescribed as a tablet, implant or injection.
Accessing MAT begins with talking to your doctor or an alcohol and drug service. They’ll know the treatments available in your area and the costs involved.
Not all doctors prescribe MAT; if your doctor does not prescribe MAT, they can refer you to another doctor or a clinic that does.
When you start MAT you may find that the medication makes you drowsy at first. This should stop as your body adjusts to the treatment. Your doctor may also adjust your dose to the level that works best for you.
Your doctor should be able to recommend additional therapies and supports to help you stay on MAT and get the support you need.
It depends on your drug-using history, the drugs you were using and your personal circumstances. Generally, people will take MAT for a few months until their opioid use has stabilised. Then, they can talk to their doctor about next steps. This may be staying at your current dose, reducing your dose or tapering off MAT completely.
Talk to your doctor to ensure you fully understand what’s involved and have realistic expectations about treatment.
No. When prescribed to treat opioid dependence and addiction, methadone and buprenorphine are medicines. They are very different from other opioids like heroin, oxycodone or fentanyl. Methadone and buprenorphine are slow-acting so a single dose lasts longer than it does for other opioids.
However, these medicines still carry some risks. If taking medication-assisted treatment for opioid dependence and addiction, it’s important that you do not use other opioids or sedatives like benzodiazepines as this can increase your risk of overdose. It’s also important that you do not stop taking methadone or buprenorphine without consulting your doctor or an alcohol and drug service.
This will depend on where you live and the programs that are available. In some places, MAT is fully subsidised (available for free). In other places, patients pay a fee per dose.
Even when you pay for it, MAT is usually cheaper than other drugs like heroin, oxycodone and fentanyl. This is because methadone and buprenorphine are acting so a dose is taken daily at most. Other opioids can wear off after a few hours.
MAT also significantly reduces the costs of drug use to your health and wellbeing.
For more information, download our Medication-Assisted Therapy (MAT) Handbook.
