Medication-Assisted Treatment: Your Questions Answered
The short answers
- MAT pairs an FDA-approved medication with therapy. The medication steadies you so the therapy can work.
- At CMAR it treats alcohol and opioid use disorder, with Vivitrol, Suboxone, Sublocade and Antabuse among the options.
- Colorado Medicaid and most major insurance plans cover MAT at CMAR, and we check your benefits first.
If you are thinking about medication-assisted treatment, you probably want to know how it works, which medication fits, whether it is safe long term and what insurance covers.
James Jackman, CAS, a Certified Addiction Specialist and Primary Therapist at CMAR who has worked in addiction treatment in Colorado since 2015, answers the questions we hear most.
What Is Medication-Assisted Treatment?
Medication-assisted treatment (MAT) is the use of an FDA-approved medication together with therapy to treat alcohol or opioid use disorder. The medication eases withdrawal and cravings, and the therapy does the deeper work, so a person can focus on recovery instead of just getting through the day.
In James’s words, MAT helps “stabilize the person and minimize the effects of post-acute withdrawal syndrome,” the lingering cravings, poor sleep and low mood that can follow detox. Our medication-assisted treatment in Denver leans on the therapy side on purpose.
What Does a MAT Program Include?
A MAT program includes a medical assessment, a prescribed medication and ongoing therapy. At CMAR it also includes group work, case management and peer support in an outpatient setting, so the medication is never the only thing doing the work.
Some clinics hand out the medication with little else. We build the therapy in because, as James puts it, the medication is “just a piece of the puzzle.” Groups include DBT, women’s groups and Inner Child work, and MAT can run alongside our PHP Program or 3-Day IOP.
What Medications Are Used in MAT?
The main MAT medications are buprenorphine (Suboxone, Subutex, Sublocade) for opioid use disorder, naltrexone (a daily pill or the monthly Vivitrol shot) for alcohol and opioid use disorder, and disulfiram (Antabuse) for alcohol use disorder. Each one does a different job.
Buprenorphine eases withdrawal and cravings, naltrexone blocks opioids and lowers alcohol cravings, and Antabuse makes drinking cause an unpleasant reaction (SAMHSA TIP 63; disulfiram label; Vivitrol label). Methadone is another option for opioids, but these are the medications CMAR offers.
Not sure which medication fits? See how MAT works at CMAR
Does Naltrexone Stop Alcohol Cravings?
Yes, for many people. Naltrexone lowers alcohol cravings, and drinking while on it tends to feel less rewarding, which makes it easier to cut back or stop. Most people notice the change within the first few weeks, especially when the medication is paired with therapy.
James says people notice “a moderate to significant decrease in craving.” Our guide on how long naltrexone takes to work covers the first weeks, and this one explains what happens if you drink on naltrexone.
Does MAT Work for Alcohol, or Only Opioids?
Yes, MAT works for alcohol as well as opioids. Naltrexone and Antabuse treat alcohol use disorder, and all three FDA-approved alcohol medications are nonaddictive, according to NIAAA. CMAR also uses comfort medications and controlled tapers for other substances, including benzodiazepines.
See how we use MAT for alcohol in Denver and MAT for opioids.
Suboxone, Vivitrol or Naltrexone: Which Is Right for Me?
It depends on the substance. Suboxone treats opioid use disorder. Naltrexone, as a daily pill or the monthly Vivitrol shot, treats alcohol use disorder and can also block opioids once you are off them. For alcohol, James calls naltrexone or Vivitrol the first line “for the overwhelming majority of patients.”
Timing matters too: Vivitrol requires being opioid-free for 7 to 10 days first (Vivitrol prescribing information), while buprenorphine can start during withdrawal. Choosing between two alcohol medications? Start with Vivitrol vs Antabuse.
How Long Do People Stay on Naltrexone or MAT?
There is no set end date. Some people stay on MAT for months and others for years, and your provider adjusts or tapers the medication as cravings settle and recovery steadies. If you are unsure, James suggests you “give it a try without committing to it long term.”
Make any change with your provider. Stopping buprenorphine suddenly can bring withdrawal back, which is why how MAT works at CMAR includes a planned taper. After stopping naltrexone or Vivitrol, opioid tolerance is lower, so using opioids carries a higher overdose risk.
Isn't MAT Just Trading One Addiction for Another?
No. Addiction is compulsive use that keeps causing harm, while MAT is a steady, prescribed dose managed by a provider. Naltrexone and Antabuse are not addictive at all, and James points out that these medications help people “show up and participate in their own lives and actually get better.”
Leaning on medication “doesn’t make you weak or less of a person,” he says. We go deeper on trading one addiction for another and how effective medication-assisted treatment is.
Can I Go to AA While on MAT?
Yes. You can take MAT and go to AA or other support groups at the same time. NIAAA notes that alcohol medications can be combined with behavioral treatment or mutual-support groups.
James sees room for medication, therapy and the 12 steps: “Whatever you believe, there is space for you to heal.”
Does Insurance Cover Vivitrol and MAT?
Most insurance plans cover MAT. CMAR works with Colorado Medicaid and is in network with plans such as Anthem BCBS, United and Optum, though coverage for a specific medication like Vivitrol depends on your plan.
Federal parity law helps: plans that cover substance use disorder treatment cannot set stricter limits than they do for medical care. The fastest way to know your costs is to verify your insurance, and Medicaid members can see our Medicaid-covered programs.
How Do I Get a Naltrexone Prescription or Start MAT in Denver?
Call CMAR, verify your insurance and complete a personalized assessment. After medical clearance, a CMAR provider can prescribe naltrexone or another MAT medication, often on the same day, and a therapist works with you from the start.
Our medical team is led by Medical Director Nathaniel Moore, MD. If you’re unsure, James would rather you ask than wait: “You really have nothing to lose by giving it a shot.” See how getting started at CMAR works or call (833) 448-0127.
CMAR treats alcohol and opioid use disorder in the Denver area with medication, therapy and groups, including PHP and IOP options and same-day starts.
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