Medication Assisted Treatment (MAT)


Medication Assisted Treatment (MAT), is endorsed by many treatment specialists, particularly doctors and psychiatrists who specialize in addiction. According to the Substance Abuse and Mental Health Services Administration (SAMSHA):

MAT is the use of medications, in combination with counseling and behavioral therapies, to provide a whole-patient approach to the treatment of substance use disorders. Research shows that when treating substance-use disorders, a combination of medication and behavioral therapies is most successful. 1

MAT has been controversial. 12-Step programs and rehabs based on them have historically been anti-medication. For example, long-term members of AA warned me that taking Antabuse, a drug that makes you violently ill if you ingest alcohol, might interfere with learning to rely on a higher power. AA called for a spiritual solution, they said, not a pharmaceutical one. (I took it anyway and it saved my ass a hundred times….)

Similarly, many Narcotics Anonymous (NA) members have objected to methadone maintenance treatment for opiate addicts on the ground that it was substituting one addiction for another; as methadone is itself an opiate, taking it meant you weren’t “straight.”

But it’s also true that for more than 25 years AA has supported the use of medication in dealing with co-occurring psychiatric problems. An official AA pamphlet,  “The A.A. Member – Medications & Other Drugs,” (originally published in 1984) states: 

“A.A. members and many of their physicians have described situations in which depressed patients have been told by A.A.s to throw away the pills, only to have depression return with all its difficulties, sometimes resulting in suicide. We have heard, too, from members with other conditions, including schizophrenia, bi-polar disorder, epilepsy and others requiring medication, that well-meaning A.A. friends discourage them from taking any prescribed medication. Unfortunately, by following a layperson’s advice, the sufferers find that their conditions can return with all their previous intensity. On top of that, they feel guilty because they are convinced that “A.A. is against pills.

It becomes clear that just as it is wrong to enable or support any alcoholic to become readdicted to any drug, it’s equally wrong to deprive any alcoholic of medication, which can alleviate or control other disabling physical and/or emotional problems.”

The pamphlet suggests a more nuanced view of medication: some meds, like sedatives and tranquilizers, are inimical to sobriety; others, like anti-depressants may be good for it.

As new medications have proven their worth, MAT has gained ground even in some 12-Step-based rehabs. Hazelden, for example, one of the country’s best-known 12-Step-based rehabs, began using the drug buprenorphine  to treat opiate addiction in 2012. Why? Because it works; it helps opiate addicts manage cravings and thereby stay straight. It literally saves lives. 2

Of course, whether to use medication assisted treatment (MAT) to assist in recovery is an individual decision that should be made in full consultation with a doctor and/or psychiatrist.

Click here for the next article in the MAT series, Medication Assisted Treatment for Alcoholism.

Click here for an article on Medication Assisted Treatment for Opiate Addiction.



[2] Hazelden Introduces Antiaddiction Medications into Recovery for First Time, Time Magazine, Nov. 05, 2012;

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