What is the Goal of Medication Assisted Treatment?
The goal of medication assisted treatment is to make recovery a reality. To do this, a strong foundation must be built and re-entry into the real world must be facilitated. If this does not happen, relapse is much more likely.
Therefore, it is imperative that clients achieve a physical and mental state where they can take full advantage of addiction treatment.
Using MAT in combination with other therapies means that clients have the best chance to get everything they need out of treatment. This includes being equipped with strategies as well as building the support network needed to handle life’s challenges and prevent relapse for years to come.
When Did Medication Assisted Treatment Begin?
The opium poppy plant has been with us since the beginning of the Earth. It was first cultivated in approximately 3500 BC. Sumerians dubbed it the “joy plant.”
In the United States, opioids date back the arrival of the Mayflower in 1620, most likely in the form of an opium/alcohol tincture called laudanum. The tincture was used as a sedative and to treat pain, diarrhea, smallpox, cholera and dysentery.
Unfortunately, wherever and whenever opioid use happens, addiction follows.
After the Civil War ended in 1865, opioid addiction emerged as a serious problem in the US. Not only were opioids prescribed to soldiers during and after that war (causing “Soldier’s Disease,” as opioid addiction was described among that group), they were also being prescribed to the general public by physicians. At the same time, illicit use (opium smoking, etc.) was also occurring on the streets.
Opiates were used in a variety of medications, from cough syrup to menstrual cramp analgesics to teething remedies. Prescriptions ranged from pain to stress and discomfort – even “female troubles.” Not surprisingly, misuse and abuse of opioids in the mid-1800s became increasingly common. Physicians began to notice that patients were developing a tolerance to and dependence on these medications.
Even Thomas Jefferson was not immune. A chronic diarrhea sufferer, Jefferson turned to opioid-based medication for relief:
“He felt so much better on the drug that he wrote to a friend, ‘with care and laudanum I may consider myself in what is to be my habitual state.’ Jefferson’s use of the word ‘habitual’ is telling. He ultimately grew his own poppies on his Monticello estate.” – The Guardian
Even though physicians were beginning to recognize the ravages of opioid addiction and be cautious about prescribing them, heroin, a modified form of morphine, entered the scene in 1898 as a brand-name cough suppressant. Not surprisingly, users developed tolerance and dependence on the drug, needing ever-increasing doses.
In recognition of this problem, the Pure Food and Drug Act of 1906 was passed into law. It required that any medication containing an opioid be labelled as such.
The origins of MAT treatment can also be traced all the way back to this time. The primitive form of today’s MAT programs emerged during the late 1800s to the early 1900s. Opioids were prescribed by physicians to those with opioid addictions, as a maintenance program. Similarly, in many municipal programs across the nation, morphine was given to treat opioid addiction. Sanatoriums were also established to try to answer the growing problem (sometimes via questionable methods). Unfortunately, many of those admitted to a sanatorium relapsed after discharge.
Funds for two new opioid addiction treatment facilities, located in Lexington, Kentucky and Fort Worth, Texas, were appropriated by Congress in 1929. This was an important development in the history of today’s “whole patient” MAT programs, because they offered psychological and psychiatric care in addition to medical services and detoxification. Although these early programs were not regarded as successful, research conducted at these facilities was credited with providing the foundation for today’s MAT programs.