Medication-assisted treatment (MAT) is a component of addiction treatment that employs the use of FDA-approved medications. These medications can be prescribed to assist individuals through the detox process, so withdrawal symptoms, particularly life-threatening ones, are less severe.
The Substance Abuse and Mental Health Services Administration (SAMHSA) states that MAT is meant to be used as part of a whole-patient approach to treatment that also includes participation in counseling and behavioral therapies. Research has shown that MAT plays an important role in the successful treatment of substance addictions. For many people, MAT leads to longer-lasting recovery following completion of a treatment program.
How MAT Works
MAT was initially developed for the treatment of addiction to prescription opioids and alcohol, but it has since been extended for the treatment of addiction to benzos, which are also prescription medications. Medication-assisted treatment for benzo addiction must be done cautiously; however, as some drugs used in MAT can be fatal when combined with anxiety medications that are derived from benzos, like Xanax or Valium.
MAT is designed to ease people through the painful process of withdrawal. Mental and physical withdrawal symptoms can be extremely uncomfortable and even life-threatening in some instances, such as with alcohol or benzo withdrawal. MAT helps by stabilizing brain chemistry in such a way that an individual does not experience intense physiological cravings for a drug. The medications used in MAT can then be tapered off slowly as the body adjusts to the removal of addictive substances.
SAMHSA explains that MAT is an approach to treatment with the main goal of providing full recovery to participants. Individuals who have participated in MAT programs have demonstrated:
- Improved survival rates
- Greater retention in treatment programs
- Decreases in illicit drug use
- Increases in the ability to gain and maintain employment
- Better birth outcomes for pregnant women struggling with substance use disorders
- Decreased risk of contracting HIV and hepatitis C
- Decreased relapse rates
The Different Types of Benzos
Benzodiazepines are prescription medications primarily designed to treat anxiety disorders. As central nervous system depressants, they work by reducing the activity of nerves in the brain. Benzos are prescribed for a number of physical and mental symptoms.
- Panic disorders
- Muscle spasms
- Sedation during surgery
- Alcohol withdrawal
Healthcare providers warn that benzos are addictive and must be prescribed with caution. Long-term use, even when under the care of a healthcare professional, can lead to tolerance and the development of an addiction. Benzos are also frequently abused for the euphoric feelings they can bring.
Common Brand Name Benzos Include:
The above medications are usually taken orally. Some come in tablet form, and others are gel capsules or liquids. Some benzos can be injected as well.
No matter which type of benzo you are taking, it is crucial not to take them along with alcohol. It is also important to avoid taking benzos while pregnant or breastfeeding as harm can be caused to the baby.
MAT for Benzo Abuse
MAT can be used as part of benzo addiction treatment, but it must be done with caution, warns the U.S. Food & Drug Administration (FDA). Concerns have been raised in the past about the safety of mixing MAT medications with benzos. Both types of medicine are generally central nervous system depressants. A hefty combination of these drugs can suppress a person’s central nervous system to the point of death.
Upon further investigation, the FDA determined that buprenorphine and methadone can be prescribed to individuals seeking MAT for a benzo addiction. They can reduce the experience of withdrawal symptoms without causing a person to feel high like benzos would. There are still considerable risks to combining these medications, but careful medication management by trained professionals can help to reduce cravings, dependency, and risk of death. Nonetheless, the FDA recommends minimizing the use of MAT medications in conjunction with benzos when possible.
Healthcare professionals have also recognized that people often use benzos in combination with opioids, alcohol, and other drugs. While there are risks of combining MAT medications with central nervous system depressants, the risk of letting people go untreated may be far greater. If healthcare professionals are faced with such a situation, they can cautiously prescribe buprenorphine or methadone as part of a well-monitored MAT plan.
In combination with patient education and participation in behavioral therapy, MAT can play an important role in individuals’ paths to recovery from benzo addiction. Other forms of treatment can achieve these goals, as well. Experts recognize that benzo dependence must be addressed through a gradual withdrawal or maintenance treatment. Prescribing medications must be closely monitored, however, to ensure negative and unwanted side effects are not experienced.
If healthcare providers do not believe MAT is the best treatment route for a particular individual, alternative methods, like tapering and managing uncomfortable withdrawal symptoms without medications, can be used. No matter what method is used to see clients through the difficult withdrawal period, comprehensive treatment plans manage dependence and then provide psychotherapeutic interventions to address all aspects of a person’s substance use disorder.
Tapering as the Primary Approach
Benzos can change the chemistry of the brain in users who have become addicted to them. For this reason, suddenly quitting can cause dangerous withdrawal symptoms. Doctors and addiction treatment specialists create tapering schedules to help people who are addicted to benzos safely and gradually eliminate the substances from their bodies.
Tapering is the most typical approach to benzo abuse treatment. Use is decreased over time until the benzos are eliminated from your system. It may take up to six weeks or longer to fully process all of the substances out of the system, but it is the safest way to do it. Just as your brain adapted to the continual presence of benzos, it must now adjust to those chemicals exiting your system.
Recent studies have found that using the tapering method in conjunction with cognitive behavioral therapy is highly effective for the treatment of benzo use disorders. The rate at which use must be tapered is determined by the individual’s capacity to handle withdrawal symptoms. Tapering typically ranges from reducing usage by 50 percent each week to reducing 10 to 25 percent every two weeks. Typical reduction timelines last anywhere from four to eight weeks. It is advised not to let tapering continue for much longer than that, so withdrawal treatment does not steal focus from the more significant issue of substance use.
Therapy can begin for those who have not completely tapered off benzos, depending on how long the tapering schedule lasts. Psychoeducation is often the first piece of treatment, followed by longer-term interventions.
Cognitive behavioral therapy is the most widely used therapy for treating addiction. It helps clients gain an understanding of their behaviors and stressors, and implement new behavioral patterns that promote healthy living and coping strategies.
Benzodiazepine misuse, much like the current opioid crisis, is a growing problem across the United States. The numbers of prescriptions filled for benzos continues to increase each year, and tolerance and dependence on these drugs are becoming more common. Recent studies have found that over five percent of American adults are prescribed benzos each year to address symptoms of anxiety and insomnia. In addition to the increase of prescriptions, illicit benzo use is on the rise too.
If someone you know needs treatment for benzodiazepine addiction, the good news is help is available. Treatment prognosis is relatively good for people who seek comprehensive care. Facilities across the country are prepared to meet your loved one’s needs and keep them safe and supported throughout the recovery process.
If you are ready to seek treatment, SAMHSA provides a free and anonymous Behavioral Health Treatment Services Locator. This service provides information and resources about treatment facilities for people seeking help with substance abuse and/or mental health problems. Additionally, SAMHSA’s national helpline can be reached at 1-800-662-4357 or 1-800-487-4889 for TTY.