Medication-assisted treatment is an option in the health-care industry that supports those suffering from chemical addiction with the use of medication. This treatment option has gone through waves of controversy impacted by the vestigial stigma from the war on drugs itself. It may seem counterintuitive to treat a ‘drug problem’ with more drugs and, there have been major successes as this treatment saves lives and offers hope to many. As the health-care industry adapts with the times, we understand that offering treatment options for those wanting support is empowering. Psycho-education ought to also be available to those seeking treatment as the withholding of information may disempower participants. While I am not trying to get off on a tangent already, please note that when we are working towards ‘trauma informed care’, as providers we must attune with the individual to see what type of information they consent to receiving as we create authentic client-centered care. If the participants are permitted to receive education around treatment options, the logistics and the social atmosphere, then they might be able to make that much more of an informed decision around what treatment might work best for them. It’s also important to note that there are many different types of treatment options and harm-reduction frameworks that are not mentioned in this write-up and are worthy of attention and awareness. For example, safe injection sites (SIS) or supervised consumption sites are not widely known in the United States of America and they are gaining traction as harm-reduction options around the world. Canada being a pioneer around SIS, their compassionate expansion of care has proven that these facilities lower overdoses and increase those choosing treatment and other harm-reduction options.¹ It turns out that offering dignity and judgment-free spaces to bridge the healthcare gaps is a key ingredient in supporting better health outcomes for those in some of the most marginalized spaces. On Point in New York² is the first safe consumption site in the USA and while this subject still holds a lot of misunderstandings, there is also a lot of positive movement.
So, back to MAT. MAT is the prescribed use of FDA approved pharmaceuticals for the treatment of managing withdrawals and supporting a smoother transition away from harsh and non-FDA approved substances. Now with the prevalence of Fentanyl, along with Fentanyl sub-categories and other more deadly chemicals, there is no excuse not to offer MAT as it is a very safe option for treatment. With withdrawal symptoms being so intense, MAT can help soften the transition and allow for more shame-free support in the above-ground treatment centers. Participants in MAT are more likely to stay in treatment because of the reduction in derailing withdrawal symptoms and because MAT also requires personalized treatment plans for participants. Every MAT clinic operates differently. The region and the type of prescription appropriate for the situation may influence the treatment plan. Because there is still stigma unfortunately attached to the MAT option, this may influence accessibility to participants. This stigma may also influence the availability and existence of the clinics to begin with. The more educated those of us working in and relying on the healthcare field are, the more we can continue to expand options for care. Along with options, lives will be saved and the ripple effect from lifting up our shared humanity will undoubtedly impact us all.
There is a history around MAT that goes as far back as psychotherapy itself. While pharmaceuticals are often associated with MAT, acute treatments to manage withdrawals, perceived or actual mental breaks included electro-shock therapy, lobotomies and other psycho-surgeries. Please note that the western medical field is largely founded on experimenting on historically marginalized groups. The Tuskegee Experiment and the Thalidomide scandal are two of many examples of abusive and unethical events in the past 100 years conducted under the guise of medical advancement. The founding of the psychotherapy field includes gaslighting survivors of abuse and conducting non-consensual and experimental procedures on victims of oppression. These intensely invasive procedures and pharmaceutical options began being used in the early 1950’s. I recently watched the new documentary Mauri³, and was both humbled and inspired by the stories of the indigenous folks surviving and thriving with each other despite the impacts of colonization. One of the persons featured in the film is a drug counselor and medicine person. He shared that he opened two drug treatment centers and that before anyone can go to the center they are required to detox for two weeks in ‘the bush’ with him. This made the audience giggle a bit, perhaps a response to the simple medicine of nature, and we could feel the group settle back in their chairs, feeling the energy shift. The bridging of the worlds and compassionate healing opportunities allow for sustainable hope to take root.
The medicines used in western healthcare have changed over the years. Natural medicines or herbs do not come into play so much because the western medical model of drugs is not compatible with herbalism. Fortunately because of Traditional Chinese Medicine and the efforts of those honoring this model, body-based natural medicines are becoming more and more accepted into western spaces. Herbs have been used by many for thousands of years to treat symptoms and root causes of chemical addiction as well as many other ailments. One beautiful thing about herbalism is that it is universal, all indigenous cultures are founded in herbalism at least for some of their medicine and healthcare. The future of healthcare is not polarized and will be respectful of all avenues of care. Holistic care is inclusive of all viable options. While natural medicines may not ever be approved by the FDA, we can educate each other so there may be that much more hope towards a more caring society we are co-creating. Right now, and for the past few years, there is a rush in the bio-pharmaceutical field to develop and patent partially-synthetic options for psychedelic assisted therapy once again, under the guise of medical advancement. The care and reverence for indigenous peoples, the spirit of the whole herbal medicine and entities, and regard for the larger lessons from psychedelics themselves such as slowness are seemingly out the window in this industry. Perhaps this is a great time to question the ethics of laying a medical solution out for issues that aren’t medical in nature to begin with. Addiction is a complex biopsychosocial phenomenon with roots in the oppressive systems. We cannot say we care about helping those suffering from addiction if we do not orient, with actions, around changing the systems of which the disorders arise and mirror.
Disulfiram is a synthetic compound used to treat alcoholism. It was one of the earlier chemicals used in the MAT protocols. Kudzu, a plant native to Asia that has naturalized and is also an invasive species in the south east USA, can be used to treat alcoholism by way of a similar mechanism to Disulfiram. While it does not cure the addict outright necessarily, it discourages drinking by creating a very unpleasant effect if alcohol is added to either of these medicines, discouraging the drinker to continue this behavior. Barbiturates, while not not targeted for alcohol, have been used to treat anxiety and insomnia by relaxing the central nervous system by way of its interactions with the GABA-receptors. This family of drugs are not so commonly used here in the USA anymore either. There are many herbal remedies that act on the GABA system such as chamomile, St. John’s wort, and Amanita muscaria or the fly agaric mushroom. All of these substances are legal. St. John’s wort, often used as a natural anti-depressant is so effective it is contraindicated with many SSRIs. Most if not all herbs and medications that act on GABA-receptors ought to be taken short term and only alongside the support of a trusted medical provider. Amphetamines were also used in the early days of MAT and had overall poor results with one addiction replacing another. There are many different natural medicines such as Iboga and LSD, a cousin of the LSA naturally derived from hawaiian baby woodrose seed and other plants & fungi, that were used 80 years ago before being banned by the federal government within the USA. We are learning so much now that research is slowly getting back on track and because some of the stigma is being replaced with education. We now have even discovered that Ketamine is naturally produced in the fungi known as Pochonia chlamydosporia.
It is also good to note that stimulants and nervines naturally exist and many of the pharmaceuticals we are familiar with have a natural origin. As our societal structures create seemingly ever-increasing pressures to be productive along with often new and unchecked stimuli, our nervous systems may be craving a more intense chemical support that mirrors this influence. In addition, with the suppression and regulation of natural medicines that are traditional for most cultures, the biological urge to explore altered states of consciousness can only be closeted for so long. In fact, with the quantum leap possibilities of positive momentum, western substance-use disorder treatment may include plant medicines within MAT treatment in the near future. This is already happening in other countries and those who have the ability to travel are simply going to those countries for more holistic healing options. Ibogaine and Iboga treatment have been available for years in other countries. It is important to note that many Ibogaine treatment centers are operating in a system without standardization for both medical safety and sourcing of Iboga. Because of the legality and safety protocols that are currently being established for Ibogaine and other natural treatments, these options could be considered medication-assisted treatment that is just not available within the USA. The Iboga plant originates from west central Africa and prioritizing care around sourcing and reciprocal relations with indigenous peoples is extremely important. The relationship with the journey also requires extreme care because unlike most other psychedelics, Iboga can be physically dangerous especially to those with heart conditions. Texas is currently moving forward with Ibogaine, the main active chemical within Iboga, research as of June 11 2025, bypassing the DEA and federal government. The DEA is approving this research even though it bypasses the fact that the chemical is currently still Schedule I. The treatment of opioid use disorder and PTSD are two of the main orientations for senate bill 2308 to be signed by Texas Governor Greg Abbott.
Other pharmaceuticals used in medicated-assisted treatment include Naltrexone which is used to treat both opioid and alcohol use disorder. John David Sinclair informed the science behind the ‘Sinclair Method’, using Naltrexone to help drinkers lose interest in alcohol by way of blocking the ‘buzz’ when alcohol is consumed. Using This method had been somewhat controversial due to the strong foundation of Alcoholics Anonymous and their abstinence based programming. Sinclair helped us understand the process of pharmacological extinction which is exactly how Naltrexone works. I have found it to be deeply disturbing that this medication option seems to not be well known considering the prevalence of alcohol use disorder. Vivitrol is a slow release version of Naltrexone that is injected and used more so for preventing opioid use relapse.
Another medication that can be taken orally or via injection is Buprinorphine aka suboxone aka subutex. Before its discovery in 1966 UK, codeine was being used more often for pain relief and Buprinorphine was found to have less side effects. In 1985 Bup was approved for use as an analgesic or for pain relief and by 2002 it was approved for treatment of opioid use disorder. The Drug Addiction Treatment Act (DATA) of 2000, a federal law expanding MAT accessibility, allowed for doctors to more easily prescribe MAT, obtain a waiver for Bup and supported funding for chemical addiction treatment. Methadone is another MAT option which requires participants to go to the clinic each time they receive the medication, sometimes daily. By expanding the accessibility of MAT options, funding Methadone clinics, and supporting the myriad of harm reduction organizations, we can find hope in the expansion of treatment options. Unfortunately overdose deaths in the USA are still on the rise. May we be humbled by this fact to sit back, to deeply exhale and open ourselves to our loving shared humanity.
- Canada Safe Injection Sites – https://www.justiceriverawrites.com/towards-bodily-autonomy
- On Point New York City – https://onpointnyc.org/
- Science and Nonduality – https://theeternalsong.org/screenings/
Resources :
Dance Safe Drug Testing – https://dancesafe.org/fentanyl/
Harm Reduction Coalition of Santa Cruz County – https://www.hrcofscc.org/