Medication Assisted Treatment for Co-occurring Disorders

Medication Assisted Treatment for Drug and Alcohol Addiction

Addiction Treatment has many facets, and sometimes Medication Assisted Treatment is not enough. According to the Substance Abuse and Mental Health Services Administration (SAHMSA), almost 40 percent of all people who experience addiction also have a co-occurring mental health condition. The most common co-occurring disorders include depression and anxiety. Other conditions may include:

• Attention-deficit hyperactivity disorder
• Eating disorders
• Obsessive-compulsive disorder
• Sleep disorders
• Impulsive disorders
• Schizophrenia
• Personality disorders

It’s not clear the role these disorders play in addiction. They may make addiction more likely or result from substance abuse. No matter the cause and effect, co-occurring disorders can complicate treatment.

Studies have found that people with co-occurring disorders are more likely to seek treatment for addiction. Unfortunately, these patients can be much harder to treat. Research shows that this population may be at a higher risk for suicide, incarceration, and homelessness than others with substance use disorder only. It can be more difficult for patients with co-occurring disorders to achieve long-term abstinence because of the challenges facing their other condition.

Common Medications Used in MAT for Addiction

Common medications used in MAT for addiction include:

• Methadone: A long-acting opioid used to reduce cravings and withdrawal symptoms in people recovering from opioid addiction.
• Buprenorphine (Suboxone, Subutex): A partial opioid agonist that helps manage cravings and withdrawal while lowering the risk of misuse.
• Naltrexone (Vivitrol, Revia): An opioid antagonist that blocks the effects of opioids and can also reduce alcohol cravings.
• Acamprosate (Campral): Helps restore chemical balance in the brain for people recovering from alcohol dependence and reduces the risk of relapse.
• Disulfiram (Antabuse): Causes unpleasant reactions if alcohol is consumed, discouraging drinking and supporting abstinence.
• Lofexidine (Lucemyra): Helps reduce withdrawal symptoms from opioids, particularly anxiety and muscle aches, without causing euphoria.

Medications for Treating Co-Occurring Mental Health Disorders

Medications used for treating co-occurring mental health disorders may include:

• Selective Serotonin Reuptake Inhibitors (SSRIs): Used to treat depression and anxiety by increasing serotonin levels in the brain, helping stabilize mood.
• Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): Treat depression, anxiety, and certain chronic pain conditions by balancing serotonin and norepinephrine.
• Benzodiazepines: Prescribed short-term for acute anxiety or agitation, helping calm the nervous system, though often closely monitored due to addiction risk.
• Mood Stabilizers (e.g., Lithium, Valproate): Used to manage bipolar disorder and mood swings, helping prevent extreme highs and lows.
• Antipsychotics (e.g., Risperidone, Olanzapine): Treat symptoms of schizophrenia, severe mood disorders, or psychosis, helping stabilize thought patterns.
• Non-Benzodiazepine Anti-Anxiety Medications (e.g., Buspirone): Help reduce chronic anxiety without the high risk of dependency associated with benzodiazepines.

Risks and Side Effects of MAT Medications

While Medication-Assisted Treatment (MAT) can be highly effective for addiction and co-occurring disorders, it is important to understand the potential risks and side effects. Each medication works differently, and individual reactions can vary. Common side effects may include nausea, headaches, dizziness, fatigue, and changes in appetite.

Certain medications, such as methadone or benzodiazepines, carry a higher risk of dependency or misuse if not carefully monitored. Others, like naltrexone or acamprosate, may cause mild gastrointestinal issues or sleep disturbances. In rare cases, serious complications such as liver damage, heart rhythm changes, or severe allergic reactions can occur, which is why medical supervision is essential.

Despite these risks, MAT medications are generally safe when prescribed and monitored by a qualified healthcare professional. Combining MAT with behavioral therapy and counseling helps maximize benefits while minimizing adverse effects. Understanding potential side effects and maintaining open communication with treatment providers ensures a safer and more effective recovery journey.

Does Insurance Cover the Cost of Medications?

Many insurance plans, including private health insurance, Medicaid, and Medicare, cover at least part of the cost of medications used in Medication-Assisted Treatment (MAT). Coverage often includes prescription costs for medications such as methadone, buprenorphine, naltrexone, and other approved treatments for addiction and co-occurring mental health disorders.

Coverage can vary depending on the plan, the specific medication, and whether treatment is received in an inpatient, outpatient, or clinic-based setting. Some plans may require prior authorization, co-pays, or step therapy, so it is important to check with your insurance provider before starting MAT.

Even if insurance does not cover the full cost, many rehab centers and clinics offer financial assistance programs, sliding scale fees, or pharmacy discounts to make treatment more accessible. Ensuring that medications are covered or affordable helps clients maintain consistency in their treatment and supports long-term recovery success.

Finding MAT Treatment for People with Co-Occurring Disorders

Finding treatment for both opioid use disorder and mental health treatment can be difficult. Some medication-assisted treatment (MAT) programs won’t accept people with co-occurring disorders while many mental health providers don’t offer MAT. This can leave patients with only half the care and support they need to gain sobriety.

MAT treatment is also vastly underutilized in many areas of the United States. While California has seen success in expanding MAT services through concentrated efforts and funding, other states have not provided the same resources to healthcare providers. Though MAT has proven effective, many people misunderstand how it works. You simply cannot take MAT and expect for your addiction to disappear. Sobriety is complex and achieved using the combination of many modalities.

As MAT services continue to expand, however, addiction treatment providers must be prepared to offer more intensive support to the nearly half of all MAT users who experience co-occurring disorders.

A Combined Dual Diagnosis Approached to Care

Evidence has long shown that medication-assisted treatment is most effective when combined psychological counseling like cognitive behavioral therapy, individual therapy, and group therapy. While medication-assisted treatment allows patients to stop drug use without withdrawal, counseling gives them the tools they need to maintain sobriety.

For patients with co-occurring disorders, medication-assisted treatment can still be effective while offering an opportunity for additional care. They may need supplemental, and more intensive, therapies to treat the additional mental health conditions. Once they are established with medication-assisted treatment, they may also need additional medicines to treat their other conditions.

While achieving sobriety is the first goal of care, each aspect of their treatment should be planned with their co-occurring disorder in mind. Each patient should be screened for additional disorders before starting MAT. Based on the severity of the co-occurring disorder, they should be offered additional resources and treatment. These resources may include:

• Inpatient treatment
• Outpatient treatment
• Community support such as vocational training, education, or support groups
• Psychotherapy, including individual, family, or group therapy
• Management by a primary care physician
• Medication management by a psychiatrist

With the right level of care and resources in place, patients have the greatest opportunity for improved mental and physical health.

Benefits of MAT for People with Co-Occurring Disorders

New studies reveal that people with co-occurring disorders who receive MAT are more likely to remain sober than patients who do not receive MAT. Patients with some conditions, like post traumatic stress disorder (PTSD), also saw a decline in those symptoms after MAT and counseling.

Even with co-occurring disorders, patients are likely to see the benefits of MAT, including:

• A decreased risk for incarceration
• A decreased risk of homelessness
• A decreased risk of unemployment
• A decreased risk for overdose and death
• A decreased risk for conditions such as hepatitis and HIV
• Improved chances for long-term abstinence

MAT may offer the best chance for patients with or without co-occurring disorders to achieve sobriety and improve their health. Addiction treatment providers should strive to offer comprehensive care to help the largest number of patients possible and address the growing opioid epidemic.

At Harmony Place, we provide both medication-assisted treatment and counseling for co-occurring disorders. We seek to give you all the tools and support you need to achieve better mental health as well as long-term abstinence. Our comprehensive services, from individual therapy to yoga, inpatient treatment to group therapy, can be personalized to fit your needs and give you the best chance at success.

At Harmony Place in Woodland Hills, California, we provide a relaxing, comfortable environment for addiction treatment and recovery with many addiction treatment program options, including our Medication Assisted Treatment program. Contact us today at (855) 652-9048 to learn more about our services and how you or your loved one can prepare for a successful rehabilitation from drug and alcohol addiction at our California treatment center.