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Medication-assisted treatment is the combination of FDA-approved medications with counseling and behavioral therapy for opioid use disorder and alcohol use disorder. It’s worth stating directly what the research on MAT shows, because stigma still affects how people think about it: MAT reduces overdose deaths by approximately 50 percent, improves treatment retention, reduces illicit drug use, and improves employment outcomes. These aren’t modest effects. For moderate-to-severe opioid use disorder in particular, MAT is the standard of care — not an alternative to “real” recovery.
At West Georgia Wellness Center, MAT is overseen by Dr. Joshua Yager, MD, our Addiction Medical Director. This physician-level oversight matters because MAT is not one-size-fits-all. The right medication, dose, and duration depend on the individual’s specific substance history, co-occurring medical conditions, and clinical response — decisions that require ongoing medical judgment, not a standing protocol.
What “Medication-Assisted” Actually Means
The term matters. MAT isn’t medication instead of therapy — it’s medication alongside therapy, with the medication addressing the neurobiological component of addiction so that therapy can address everything else. Someone in active opioid withdrawal or experiencing severe cravings cannot meaningfully engage in individual or group therapy. Once the physiological component is stabilized through appropriate medication, the therapeutic work becomes possible.
This is also why MAT delivered without adequate therapy is insufficient. The medications do their job; they don’t do therapy’s job. At West Georgia Wellness Center, MAT runs concurrently with individual therapy, group therapy, and in many cases EMDR or schema work that addresses the underlying trauma and psychiatric conditions that drove substance use in the first place.
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Medications Used for Opioid Use Disorder
Buprenorphine (Suboxone, Sublocade)
Buprenorphine is a partial opioid agonist — it activates opioid receptors enough to eliminate withdrawal symptoms and cravings without producing the euphoria of full agonists. It has a “ceiling effect” that limits respiratory depression risk, making it significantly safer in overdose than methadone or full opioids. Buprenorphine is available as a sublingual film or tablet (Suboxone, which also contains naloxone to deter misuse) or as a monthly injectable formulation (Sublocade) that eliminates the daily adherence requirement.
Research consistently shows buprenorphine reduces illicit opioid use, improves retention in treatment, and reduces overdose deaths. It is the most widely prescribed MAT medication for opioid use disorder in the United States.
Naltrexone (Vivitrol)
Naltrexone is an opioid antagonist — it blocks opioid receptors entirely, meaning that if opioids are used, they produce no euphoric effect. Unlike buprenorphine, it has no abuse potential and requires complete opioid detoxification before initiation. In its monthly injectable form (Vivitrol), it eliminates the daily adherence problem that affects oral naltrexone compliance. Naltrexone is also FDA-approved for alcohol use disorder, where it reduces the rewarding effects of alcohol and decreases relapse rates.
Methadone
Methadone is a full opioid agonist with a long half-life. It is highly effective for opioid use disorder but carries a more complex safety profile than buprenorphine — particularly regarding cardiac effects and overdose risk at higher doses. Federal regulations require methadone for OUD to be dispensed through specialized Opioid Treatment Programs (OTPs), not prescribed in standard clinical settings. At West Georgia Wellness Center, clients who are stable on methadone from an existing OTP program can continue that medication during residential treatment with appropriate coordination.
Medications Used for Alcohol Use Disorder
Naltrexone
As with opioid use disorder, naltrexone for AUD works by blocking the opioid-mediated reward associated with alcohol consumption. When alcohol doesn’t produce its expected effect, the drive to drink is significantly reduced. Available as a daily oral tablet or monthly injection (Vivitrol).
Acamprosate
Acamprosate reduces the protracted withdrawal symptoms — anxiety, insomnia, dysphoria — that persist for weeks to months after acute alcohol detox and drive relapse in many people who’ve completed detox successfully. It doesn’t address cravings in the same way naltrexone does; it specifically targets the neurological imbalance that makes early sobriety uncomfortable.
Disulfiram (Antabuse)
Disulfiram works through deterrence: it inhibits alcohol metabolism, causing an intensely unpleasant reaction (flushing, nausea, palpitations) within minutes of alcohol consumption. It’s not appropriate for everyone and requires strong motivation and monitoring, but for the right individual it can function as a behavioral commitment device during early recovery.
Addressing the “Replacing One Drug with Another” Concern
This is the most common objection to MAT, and it deserves a direct answer. Buprenorphine and methadone do activate opioid receptors — that’s how they work. But “replacing one drug with another” implies equivalence that doesn’t exist clinically. The difference between uncontrolled opioid use and prescribed, physician-supervised MAT is the difference between active addiction with all of its consequences (overdose, disease transmission, legal problems, destroyed relationships) and a medically stable person who can work, parent, and engage in treatment. The evidence on this is not equivocal.
For a more extended discussion of this and the evidence base for MAT, see SAMHSA’s Treatment Improvement Protocol TIP 63, which comprehensively addresses medication for opioid use disorder.
How Long Does MAT Last?
This is highly individual. National guidelines from SAMHSA and ASAM recommend against arbitrary time limits on MAT — the evidence shows that longer duration is associated with better outcomes. Some people use MAT for one to two years and successfully taper off. Others remain on maintenance medication indefinitely, similar to how someone with diabetes manages insulin long-term. Dr. Yager works with each client to develop a realistic medication plan based on their specific history, treatment goals, and clinical response.
Frequently Asked Questions About MAT
Can I start MAT while in residential treatment at West Georgia Wellness Center?
Yes. MAT initiation during residential treatment is common and often clinically appropriate. The timing depends on your specific substance history and detox status — buprenorphine initiation, for example, requires that you’re in early withdrawal before the first dose to avoid precipitated withdrawal. Dr. Yager conducts a thorough medical evaluation to determine the appropriate medication and timing.
Does insurance cover MAT?
Yes, in most cases. The Mental Health Parity and Addiction Equity Act requires that MAT be covered at the same level as equivalent medical treatments. Most commercial insurance plans, Medicaid, and Medicare cover FDA-approved MAT medications. Coverage details vary — our insurance verification team confirms your specific benefits before admission at no cost.
What happens to my MAT after I leave residential treatment?
Discharge planning for clients on MAT includes identifying a prescribing provider for continued medication management after residential treatment. We do not discharge clients on MAT without a clear plan for medication continuity — the period immediately following residential treatment is high-risk, and medication gaps during that window dramatically increase relapse and overdose risk.
Is MAT appropriate if I have a co-occurring mental health condition?
Yes — in fact, co-occurring mental health conditions are one of the strongest reasons to consider MAT. Untreated opioid use disorder or alcohol use disorder in someone with depression, PTSD, or bipolar disorder dramatically complicates psychiatric treatment. MAT stabilizes the substance use component so that psychiatric treatment can be more effective. Dr. Yager and Dr. McQuirt coordinate closely on clients with dual diagnoses.
Call our admissions team at 470-625-2466 to discuss whether MAT is appropriate as part of your residential treatment plan. Our team is available 24 hours a day, 7 days a week.
