How Does MAT Work?
Substance use disorders change brain chemistry. Opioids bind to receptors that control pain, mood, and reward. Alcohol disrupts GABA and glutamate systems that regulate anxiety, sleep, and cognitive function. When someone stops using, the brain cannot immediately return to normal functioning. Cravings, withdrawal symptoms, and neurological instability make early recovery extremely difficult without pharmacological support. MAT medications address this at the neurological level:For Opioid Use Disorder:
Naltrexone (Vivitrol): An opioid antagonist administered as a monthly injection. Blocks opioid receptors so that opioids produce no effect if used. Eliminates the daily compliance burden of oral medications. Buprenorphine (Sublocade, Brixadi): Partial opioid agonists administered as monthly or weekly injections. Activate opioid receptors at a stable, controlled level that reduces cravings and prevents withdrawal without producing a high. Methadone: A full opioid agonist dispensed daily at licensed clinics. Prevents withdrawal and reduces cravings. Trailhead collaborates with external methadone clinics for clients who need this option.For Alcohol Use Disorder:
Naltrexone (Vivitrol): The same medication used for opioid use disorder. Reduces the reward response to alcohol, making drinking less reinforcing over time. At Trailhead Treatment Center, injectable MAT (Vivitrol, Sublocade, Brixadi) is available on-site and can be combined with PHP, IOP, individual therapy, or received as a standalone service.Addressing the “Replacing One Addiction” Concern
This is the most common objection to MAT, and it is not supported by evidence. Addiction is characterized by compulsive use despite negative consequences, loss of control, and escalating doses. MAT medications are taken at stable, prescribed doses that do not produce intoxication, do not escalate, and do not cause the behavioral patterns associated with addiction. Vivitrol and Sublocade are long-acting injectables administered monthly by a clinician. There is no daily pill to skip, no prescription to misuse, and no street value. The medication works in the background while the person does the therapeutic work that builds long-term recovery. Refusing MAT for opioid use disorder is like refusing insulin for diabetes because you do not want to “depend on a medication.” The brain changes caused by opioid use require medical intervention alongside behavioral treatment.Who Benefits Most from MAT?
MAT is most effective for:- People with opioid use disorder (prescription opioids, heroin, fentanyl)
- People with alcohol use disorder who experience intense cravings
- People with a history of relapse after non-medication treatment
- People stepping down from detox who need neurological stabilization
- People in early recovery who need craving reduction while building coping skills
