Medication-Assisted Treatment and Common Misconceptions

Summary

This presentation, supported by SAMHSA and ACYF, clarifies misconceptions about Medication-Assisted Treatment (MAT) for opioid use disorders. MAT combines medication with counseling and mental health therapies, proving more effective than non-pharmacological treatments. Common myths include MAT being a drug substitution or having a fixed duration; however, it's a long-term, individualized approach with no adverse effects on cognitive or physical functions. MAT is also the best option for pregnant women, promoting healthy fetal development. The script advocates for targeted messaging, ongoing training, and cross-system collaboration to dispel stigma and improve understanding of MAT.

Takeaways

• 🏥 The presentation is supported by SAMHSA and co-funded by ACYF, but the content reflects the presenters' views, not necessarily those of the funding bodies.
• 💊 Medication-assisted treatment (MAT) combines medication with counseling and mental health therapies for opioid use disorders.
• 🔬 Despite evidence of MAT's effectiveness, it is often misunderstood and underutilized due to misconceptions.
• 🚫 A common myth is that MAT simply substitutes one drug for another, which is incorrect as MAT medications alleviate withdrawal symptoms and cravings without causing euphoria or addiction.
• 🌡 MAT medications like methadone and buprenorphine have gradual effects and maintain stable drug levels in the brain, avoiding the cycle of euphoria, crash, and craving.
• 👩‍⚕️ MAT is closely monitored by medical professionals, and when used properly, does not adversely affect intelligence, mental capability, physical functioning, or employability.
• 👶 There is no fixed duration for MAT; it can be used safely for months, years, or even a lifetime, similar to treatments for other chronic diseases.
• 🤰 MAT is also appropriate for pregnant women, as it supports healthy fetal development and reduces risks associated with untreated opioid use disorders.
• 🤝 Misconceptions about MAT can stigmatize and limit recovery options, affecting family reunification chances.
• 📢 Targeted messaging, ongoing training, and cross-system collaboration are strategies to counteract misconceptions and improve understanding of MAT.
• 📚 Additional resources and information on MAT can be found on the provided SAMHSA and NCSACW websites.

Q & A

What does the acronym MAT stand for in the context of the presentation?

MAT stands for Medication-assisted treatment, which is a treatment approach for substance use disorders that combines medication with counseling and mental health therapies.

What is the primary goal of the motion graphic mentioned in the script?

The primary goal of the motion graphic is to address common misconceptions surrounding MAT and to offer effective strategies that courts and child welfare agencies can use in their practice.

Why is MAT often misunderstood and underutilized despite evidence of its effectiveness?

MAT is often misunderstood and underutilized due to misconceptions such as the belief that it is merely substituting one drug for another, and that true recovery only occurs when a person is off MAT medications.

How do the medications used in MAT differ from illicit substances like heroin?

Medications used in MAT, such as methadone or buprenorphine, have gradual onsets of action and produce stable levels in the brain, eliminating the cycle of euphoria, crash, and craving associated with illicit substances like heroin.

What are the benefits of MAT medications for individuals in treatment?

MAT medications relieve withdrawal symptoms and psychological cravings, leading to chemical balance in the body. They allow individuals to stabilize their behaviors, engage in treatment services, and build a support system beneficial for themselves and their children.

Why might some judges and caseworkers have concerns about the long-term use of MAT?

Some judges and caseworkers may believe that long-term use of MAT is unnecessary or harmful, and they may expect parents to be stepped down from MAT medications as soon as possible, reflecting a misconception about the appropriate duration of MAT.

How should the decision to stop MAT be approached according to the script?

The decision to stop MAT should be discussed with a doctor and made on an individual basis, similar to plans to stop other medications for chronic diseases. It is not based on a set amount of time.

What is the script's stance on MAT as a treatment approach for pregnant women with opioid use disorders?

The script identifies MAT as the best treatment option for pregnant women with opioid use disorders, as it helps the mother engage in treatment, reduces the risk of relapse and overdose, and is beneficial for healthy fetal development.

How can misconceptions about MAT perpetuate stigma and impact families?

Misconceptions about MAT can perpetuate stigma, limit parents' recovery options, and lower the likelihood of family reunification by influencing case planning and permanency decisions.

What strategies are suggested in the script to debunk misconceptions about MAT and promote better understanding?

The script suggests targeted messaging to emphasize MAT as an evidence-based approach, ongoing training through online courses and toolkits, and cross-system collaboration to develop a shared understanding among service providers.

Where can one find more resources and information about medication-assisted treatment as mentioned in the script?

More resources and information about medication-assisted treatment can be found at the provided URLs: https://ncsacw.samhsa.gov/topics/medication-assisted-treatment.aspx and https://www.samhsa.gov/medication-assisted-treatment.

Outlines

00:00

💊 Medication-Assisted Treatment (MAT) Overview

This paragraph introduces the concept of Medication-Assisted Treatment (MAT), a comprehensive approach that integrates medication with counseling and mental health therapies for opioid use disorders. It clarifies that MAT is more effective than other treatments and addresses misconceptions, such as the belief that MAT is merely substituting one drug for another. The paragraph explains the physiological differences between illicit substances like heroin and MAT medications like methadone or buprenorphine, emphasizing the latter's role in stabilizing brain chemistry and preventing the cycle of euphoria, crash, and craving. It also highlights the importance of medical supervision and the lack of adverse effects on cognitive and physical functions when MAT is administered properly.

05:07

👶 Misconceptions and MAT for Pregnant Women

This section dispels the myth that MAT is not suitable for pregnant women, arguing that it is actually the best option for healthy fetal development. It points out that MAT helps mothers adhere to treatment, reducing the risk of relapse, overdose, and associated infectious diseases. The paragraph also tackles the misconception about a set duration for MAT use, stating that it can be safely administered for months, years, or even a lifetime, similar to chronic disease treatments. The importance of discussing cessation plans with a doctor is emphasized, rather than expecting a rapid step-down based on unfounded expectations.

🔗 Additional Resources on MAT

The final paragraph provides links to additional resources for further information on Medication-Assisted Treatment. It directs interested individuals to the National Center for Substance Abuse in Child Welfare and the Substance Abuse and Mental Health Services Administration websites, offering a gateway to more detailed knowledge, research outcomes, and educational materials related to MAT.

Keywords

💡Medication-assisted treatment (MAT)

MAT is a comprehensive treatment approach for individuals with substance use disorders, which combines medication with counseling and mental health therapies. It is central to the video's theme as it addresses misconceptions about MAT and highlights its effectiveness compared to other treatments. The script emphasizes that MAT is more than just medication, aiming to stabilize behaviors and support recovery.

💡Opioid use disorders

Opioid use disorders refer to a medical condition characterized by compulsive opioid drug use, leading to harmful consequences. The video discusses MAT as a treatment specifically for these disorders, illustrating the importance of MAT in managing withdrawal symptoms and cravings, which are key aspects of opioid addiction.

💡Misunderstandings

Misunderstandings in the context of the video relate to the common misconceptions about MAT, such as the belief that it is merely substituting one drug for another. The script aims to debunk these misconceptions to promote a better understanding of MAT's role in recovery and its benefits over other treatments.

💡Withdrawal symptoms

Withdrawal symptoms are the physical and psychological effects experienced when reducing or stopping the use of a substance to which one has developed a dependence. The video explains that MAT medications help relieve these symptoms, which is crucial for individuals in recovery from opioid use disorders.

💡Cravings

Cravings are intense desires for a substance, often experienced by those with substance use disorders. The script highlights how MAT can help control cravings, which is essential for preventing relapse and supporting ongoing recovery.

💡Methadone and buprenorphine

Methadone and buprenorphine are specific medications used in MAT that help to stabilize drug levels in the brain and reduce the cycle of euphoria, crash, and craving associated with illicit opioid use. The video emphasizes the importance of these medications in the MAT approach.

💡Euphoria

Euphoria is a feeling of intense happiness or excitement, often associated with the initial effects of using certain substances. The video contrasts the immediate euphoria caused by substances like heroin with the stable effects of MAT medications, which do not produce such intense highs.

💡Recovery

Recovery in the context of the video refers to the process of regaining control over one's life after addiction. MAT is presented as a key component of recovery, helping individuals to stabilize their behaviors and engage in treatment services.

💡Stigma

Stigma refers to the negative attitudes and discrimination associated with certain conditions or treatments, such as MAT. The video discusses how misconceptions about MAT can perpetuate stigma, which can limit recovery options and affect the likelihood of family reunification.

💡Cross-system collaboration

Cross-system collaboration is the coordination and cooperation between different service providers, such as child welfare agencies, courts, and substance use treatment providers. The video suggests that this collaboration is an effective strategy for debunking misconceptions about MAT and promoting a better understanding of its benefits.

💡Pregnant and parenting women

The video addresses misconceptions about MAT's suitability for pregnant and parenting women with opioid use disorders. It clarifies that MAT is actually the best treatment option for these women, as it helps ensure healthy fetal development and reduces risks associated with untreated addiction.

Highlights

The presentation was supported by SAMHSA, CB, and ACYF, but the views expressed are solely those of the presenters.

Medication-assisted treatment (MAT) combines medication with counseling and mental health therapies for opioid use disorders.

Despite evidence of MAT's effectiveness, it is often misunderstood and underutilized.

The motion graphic aims to address misconceptions about MAT and offer strategies for courts and child welfare agencies.

A common misconception is that MAT is just substituting one drug for another, which can influence case planning and decisions.

MAT medications relieve withdrawal symptoms and cravings without causing the cycle of euphoria, crash, and craving seen with illicit substances.

Methadone and buprenorphine, used in MAT, have gradual onsets and produce stable drug levels in the brain.

MAT medications are closely monitored and, when properly dosed, have no adverse effects on intelligence, mental capability, physical functioning, or employability.

MAT helps parents stabilize behaviors, engage in treatment, and build support systems beneficial for them and their children.

There is a misconception that MAT should only be used for a set amount of time, but it can be safely used for months, years, or even a lifetime.

Judges and child welfare workers may expect rapid discontinuation of MAT, but this is not realistic for most parents with opioid use disorders.

MAT is the best treatment option for pregnant women with opioid use disorders, promoting healthy fetal development and reducing risks.

Misconceptions about MAT can perpetuate stigma and limit recovery options, affecting family reunification.

Targeted messaging, ongoing training, and cross-system collaboration are effective strategies to debunk MAT misconceptions.

Targeted messaging emphasizes MAT as an evidence-based approach including medication, counseling, and mental health therapies.

Ongoing training can involve online courses and toolkits to promote education and awareness of MAT research and outcomes.

Cross-system collaboration involves developing a shared understanding among child welfare agencies, courts, and substance use treatment providers.

For more resources on MAT, visit the provided SAMHSA and NCSACW websites.

Transcripts

Narrator: This presentation was supported  by contract number HHSS270201700001C from  

the Substance Abuse and Mental Health Services  Administration (SAMHSA), co-funded by Children’s  

Bureau (CB), Administration on Children, Youth and  Families (ACYF). The views, opinions, and content  

of this presentation are those of the presenters  and do not necessarily reflect the views,  

opinions, or policies of SAMHSA, ACYF, or the U.S.  Department of Health and Human Services (HHS).

Narrator:  

Medication-assisted treatment or MAT is a  treatment approach that combines medication  

with counseling and mental health therapies.  Despite the empirical evidence demonstrating MAT  

to be more effective for opioid use disorders than  other substance use treatment without medications,  

MAT continues to be  misunderstood and underutilized.  

The purpose of this motion graphic is to address  some of the common misconceptions surrounding MAT  

and offer effective strategies that courts and  child welfare agencies can use in their practice.

One of the most common misconceptions  about MAT is that recipients are simply  

substituting one drug for another. Some  judges and caseworkers share the view that  

parents are not actually in recovery until  they are off the MAT medications. These  

types of views can influence case  planning and permanency decisions. 

MAT is not replacing one drug for another. The  medications used in MAT relieve the withdrawal  

symptoms and psychological cravings that  cause chemical imbalances in the body. 

Heroin, for example, causes an almost immediate  period of euphoria that wears off quickly and ends  

in a "crash", causing intense cravings. This cycle  of euphoria, crash, and craving—sometimes repeated  

several times a day—is indicative of addiction  and results in severe behavioral disruptions. 

In contrast, medications used in MAT, such as  methadone or buprenorphine, have gradual onsets  

of action and produce stable levels of the drug  in the brain. As a result, people maintained on  

these medications do not experience that  cycle of euphoria, crash, and craving as  

they do when they use illicit substances. To further distinguish MAT medications from  

illicit substances, MAT medications are closely  monitored by a medical professional and research  

has shown that when provided at the proper dose,  medications used in MAT have no adverse effects on  

a person’s intelligence, mental capability,  physical functioning, or employability. 

By controlling the symptoms of substance use  disorders, such as withdrawal and cravings,  

parents can stabilize their behaviors,  engage in treatment services,  

and build a support system that is  beneficial for both them and their children. 

Another common misconception is that there is a  set amount of time that a person should use MAT,  

and any use past this time is unnecessary  or even harmful. With this misconception,  

judges may expect parents receiving MAT to be  stepped down from methadone or buprenorphine as  

soon as possible and child welfare workers  may be concerned that long term use of MAT  

is not compatible with successful parenting. While a rapid step down of MAT may be feasible  

in some cases, this expectation is not realistic  for the majority of parents affected by opioid use  

disorders and child welfare involvement. People  may safely receive MAT for months, years, or  

even a lifetime – and similar to other medications  for chronic diseases, people should discuss plans  

to stop MAT with a doctor before doing so. Another misconception is that MAT is not an  

appropriate treatment approach for pregnant and  parenting women with opioid use disorders because  

of the potential adverse effects it may have on  the developing fetus or infant. However, MAT has  

been identified as the best treatment option for  healthy fetal development because it has proven to  

help the mother engage and adhere to treatment,  reduce the risk of relapse, reduce the risk of  

overdose death, and reduce the risk of contracting  associated infectious diseases such as HIV.

Misconceptions surrounding  MAT can perpetuate stigma,  

ultimately limiting parents’ recovery options and  lowering the likelihood of family reunification.  

Targeted messaging, ongoing training, and  cross-system collaboration are effective  

strategies to debunk the misconceptions  and promote a better understanding of MAT. 

Targeted messaging is important to reiterate that  MAT is an evidence-based treatment approach that  

includes, not just medication, but a program  of counseling and mental health therapies. 

Ongoing training could take many forms  including online courses and toolkits  

to promote education and awareness of the  research and outcomes associated with MAT. 

Cross-system collaboration should include  developing a shared understanding of the  

various service providers that these  families are involved with. This shared  

understanding helps to promote trust and increase  communication between child welfare agencies,  

courts, and substance use treatment providers. Narrator:  

For more resources and to learn  about this topic, please visit:  

https://ncsacw.samhsa.gov/topics/medication-assisted-treatment.aspx,  and  

https://www.samhsa.gov/medication-assisted-treatment