What to Expect
What is MAT?
MAT stands for “medication assisted treatment.” It means a medication that can help people stop using opioids. It is very common to need help stopping opioids, even if you only take opioid pain medication as directed by your provider. This is because opioids make changes in the body that cause it to need opioids to feel “normal.” This is called physical addiction, or opioid dependence. Usually, MAT works best when a medication is used together with counseling and social support. There are several medications that are used for MAT, but this overview focuses on buprenorphine-naloxone. Your provider will help you decide if buprenorphine-naloxone is the right medication for you.
Buprenorphine-Naloxone (also known as Suboxone or other brand names) is a pill or film you can take by mouth. It is very effective in preventing opioid cravings and withdrawal symptoms. The buprenorphine part works by stopping other opioids from working in the body, and it stops cravings for opioids. We often recommend buprenorphine-naloxone because:
- It helps you feel normal: It is long lasting and doesn’t have highs and lows like opioids. It also stops cravings so instead of thinking about opioids you can focus on the more important things in your
- It’s convenient: It is usually taken daily at home, so many people find it more comfortable and convenient than methadone
- It helps with pain: If you are taking opioids for pain, buprenorphine-naloxone is also a very effective pain reliever but without the highs and lows of opioid pain medications. If you are stopping opioids but still need help for pain, you provider will help you make a new pain management plan with buprenorphine-naloxone.
- It helps you stay on track: It includes naloxone, so it is not possible to “get high” by injecting it. The naloxone doesn’t work when you take it by mouth. However, injecting it can cause withdrawal symptoms such as pain, cramps, vomiting, diarrhea, anxiety, sleep problems, and cravings. So please don’t inject it!
What are the Side Effects?
Side effects are different for everyone. The most common side effects are headache, withdrawals, pain, heavy sweating, insomnia, weakness, constipation, and stomach pain. Many
of these symptoms are related to withdrawal due to switching medications or missing doses. Talk to your provider about any problems you have while you are using this medication.
Buprenorphine-naloxone startup is a several day process which is sometimes called, “induction”. You and your provider will decide together when and where the startup will happen. The process looks something like this:
- You will set an in-person or phone startup appointment with your provider. You should plan to be in the clinic or have free time at home for the whole It is also possible that your startup may take longer, usually 1-2 days.
- You will be self-detox anywhere from 16 hours to 48 hours before the appointment. This may be from 16-48 hours depending on what and how much opioids your body is used to.
- You show up at the clinic or receive the call for your startup appointment. The provider will ask you about your opioid withdrawal symptoms. It is important to tell the truth about when you last used opioids and how your withdrawal symptoms feel. If you are not in withdrawal, the medication will not work, and it will cause serious withdrawal symptoms called “precipitated ”
- If you are in withdrawal, your provider will tell you to take your first dose. You should feel better within 30
- If you are not in withdrawal,your provider might ask you to wait a little while, or even reschedule your appointment if you are not in
- Your provider and their staff will check on you throughout the day. They provider might have you take more doses during the startup to find the right dose for you, so it is important to tell your provider and their staff how you are
- Your startup might last more than 1 day. You must come in or continue with phone contact every day until your provider says that the startup is
When your startup is done, your provider will want to see you regularly to make sure you are on the right dose and you have the support that you need. Tell your provider if you have triggers or cravings at any time. They might try adjusting your dose, or help you get connected with counseling or other support programs.
You will also begin working on treatment goals. After achieving your treatment goals and feeling confident with your progress, you and your provider might consider tapering off of the medication. This is not required and there is no set timeline. You, your provider, and possibly your counselor will decide when the time is right for you. Your dose will be tapered slowly, minimizing withdrawal symptoms.
Adapted from Southeast Health Group / IT MATTTRs program overview. Available at: https://www.asam.org/docs/default-source/education-docs/mat-program-overview_5-2-2017.pdf?sfvrsn=ab0640c2_2