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  • Marty Lythgoe

Medication-Assisted Treatment - An Inconvenient Truth

Studies have shown that Medication-Assisted Treatment (MAT) increases treatment retention 25% and increases recovery rates 35%, and yet many in the recovery field are resistant to accepting this as an effective part of treatment. Why??

  • We have strong feelings about what constitutes recovery.

  • We are conflicted by scientific evidence vs. our own philosophy.

  • Personal experience can be both powerful and limiting: It is difficult to know what we don't know. We avoid things we don't understand. Our beliefs influence how we present treatment options to our clients.

Substance use disorders are treatable brain conditions with bio-psycho-social-spiritual origins that exhibit a chronic and relapsing course. The "Reward Pathway" (or "Dopamine Pathway" or "Pleasure Pathway") is the primary brain circuit involved in addiction. MAT stabilizes this pleasure pathway and allows for psycho-social interventions. MAT, using FDA-approved medications (Methadone, Buprenorphine, Naltrexone, Acamprosate) should not be equated with use of alcohol or other drugs of abuse. There is a difference between using drugs and taking medication.


We need to consider our need to stop treatment based on philosophy alone and begin treatment based on evidence and science. At the same time, we must move beyond settling for harm reduction and move along a continuum of care toward transformation of the human being. Reducing craving through medication-assisted treatment is merely a technique along the way from sick to well. Let's not lose sight of abstinence as a goal.


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