Medication-Assisted Treatment (MAT) for Veterans: Benefits & Coverage

Medication-assisted treatment, or MAT, is an approach for treating certain substance use disorders that combines medication and counseling. Some of the treatment medications used can help to ease withdrawal symptoms, while others can be used on a more long-term basis to help decrease continued substance misuse—such as that involving alcohol or opioids—by helping to manage cravings, decreasing the reward of drinking/drugs, and otherwise stabilizing certain body processes that have been previously disrupted by significant drug or alcohol use.¹

MAT is often administered in a highly regulated medical environment, as some of the FDA-approved medications have the potential for abuse. As a result, depending on the substance being treated, only certain programs may be able to provide MAT.^{2, 3} If you are a veteran seeking treatment, MAT may be available as part of a comprehensive treatment program, whether through the VA or private facilities covered by veterans’ health insurance.⁴

What Is Medication-Assisted Treatment (MAT)?

Medication-assisted treatment can provide a dimension to an individual’s holistic treatment plan by augmenting therapy sessions with medication management. This allows treatment programs to address the biological and medical aspects of addiction while also treating the social, emotional, and mental occurrences that can lead to addiction. MAT can help people manage withdrawal symptoms during detox, and can also assist in reaching and maintaining recovery.

If you have an opioid use disorder (heroin, fentanyl, or oxycodone), or an alcohol use disorder there are different types of MAT that address opioid and alcohol addiction.¹ It’s best to communicate with a medical professional to determine if MAT is right for you, and how best to incorporate it into your overall addiction treatment plan.

How Does It Work for Opioid Use Disorder and Alcohol Use Disorder?

There are various uses for medications in treatment programs. One of the most common uses is to help manage the symptoms of withdrawal that can occur during detox. Medications may be prescribed to help manage withdrawal symptoms that result from the cessation of opioid or alcohol use. When a person experiences opioid withdrawal, they are at risk of the following symptoms⁵ :

• Nausea.
• Vomiting.
• Muscle pain.
• Anxiety.
• Diarrhea.
• Sweating.

These symptoms can be intense and uncomfortable and as a result, may cause a person to relapse as a way to alleviate the discomfort. MAT is given to help minimize these symptoms in hopes of preventing relapse. Common medications used in MAT therapy include buprenorphine and methadone.

Buprenorphine is a partial opioid agonist (acts the same way an opioid does) that can help reduce physical withdrawal symptoms and cravings.²

After a person has stabilized from opioid withdrawal, they may continue taking buprenorphine as part of a larger treatment plan, though usually at smaller doses.² If needed, they may also be prescribed methadone, a long-acting opioid.³ Methadone can help reduce cravings for opioids, though usually needs to be administered by medical professionals on-site at a licensed clinic or treatment facility.^{6, 3}

Withdrawing from alcohol is not only uncomfortable but also can be dangerous, in some instances. Common symptoms of alcohol withdrawal include the following:

• Nausea.
• Vomiting.
• Headache.
• Seizures.
• Tremors.
• Anxiety.
• Confusion.
• High blood pressure.
• Elevated heart rate.
• Sweating.

Because of the potential risks, sedating medications (such as benzodiazepines) are often administered as part of a medical detox to manage acute alcohol withdrawal symptoms. Once the individual is stabilized and no longer at risk of severe withdrawal symptoms or complications, longer-term medications may be initiated as part of an MAT approach to managing an alcohol use disorder. Acamprosate, disulfiram, and naltrexone are common drugs used in the treatment of alcohol use disorders, and are usually prescribed after an individual has detoxed and stabilized.⁶

MAT Medication List & Addiction Treatment

There are several types of medications that may be used in the treatment of substance use disorders. The forms of MAT used to treat opioid use disorders include:^{2, 3, 9}

• Buprenorphine, which can help manage the symptoms of opioid withdrawal and can also be given long term to help people maintain recovery and decrease cravings for opioids. Buprenorphine when combined with naloxone is also sold under the names Subutex and Suboxone.
• Naltrexone, another type of MAT that blocks the effects of opioids, so if you ingest any type of opioid while on naltrexone, you will not feel euphoria or any other type of effects of opioids, but instead will experience opioid withdrawal symptoms. As a result, naltrexone is used for long-term opioid use disorder and not in the acute withdrawal phase.
• Methadone is another type of MAT that can help with opioid withdrawal symptoms and also is given long term to help people avoid relapse.

In addition, a medication assisted treatment program can be used for treating alcohol use disorders. These types of MAT can include:¹⁰

• Disulfiram, which can cause a very unpleasant reaction when people use alcohol while taking it. They may experience nausea, vomiting, and a racing heart.
• Naltrexone will also block the impact of alcohol on the body, and if someone uses alcohol while taking naltrexone, they won’t feel any of the effects of alcohol.
• Acamprosate, which helps to control cravings and maintain abstinence from alcohol.

Is Medication-Assisted Treatment Covered by Veteran Benefits?

The VA understands the importance of MAT for treating substance use disorders.¹¹ It’s important to remember that MAT is often just one part of a larger treatment plan, and whether or not you are able to participate in MAT will depend on your treatment needs. While the VA is able to offer MAT drug and alcohol rehab, these programs may not be available at your local VA. It’s important to reach out to your VA representative to determine the extent of nearby and accessible care.

Medicaid & Medicare

Medicare and Medicaid offer coverage for the treatment of substance use disorders.^12,13 Medicare recently approved MAT for opioid use disorders.¹³ However, your approval to be treated with MAT may vary based upon your needs and situation. In addition, with Medicaid, the types of coverage offered can vary from one state to another based upon each state’s decision on how to spend substance use disorder treatment dollars.¹²

Can I Lose Veteran Benefits for Seeking Treatment?

No, you cannot lose your benefits if you seek treatment and are taking MAT. The VA offers MAT as part of its treatment programs. TRICARE, a health insurance program for military personnel, also offers coverage for MAT drug rehab. The various types of MAT that are offered are prescription medications that are given only under a doctor’s approval.

How to Find a MAT Program for Veterans

If you are seeking help with an opioid use disorder or an alcohol use disorder, you can start with the VA. The VA offers a variety of inpatient and outpatient treatment programs that also incorporate MAT. However, you can also get treatment at private providers who take Tricare. You can find providers other than the VA by searching the treatment locator offered by SAMHSA.

An important aspect of treatment for veterans may be peer support and treatment for co-occurring disorders like PTSD. Oftentimes, facilities that provide veterans-specific programs can address these concerns and should be considered for veterans seeking treatment. Another important factor to remember when seeking treatment is if the facility is part of the VA. If you find a facility that you want to attend that is not part of the VA, you should check and see if they are a part of the VA’s Community Care Network. The Community Care network allows veterans enrolled in the VA to attend select treatment facilities that work with the VA and accept VA health insurance.

How Long Does MAT Last?

The length of treatment using MAT does vary from one person to another. Some people use MAT for the short-term to help them manage withdrawal symptoms, but others use MAT on a long-term basis, that could extend throughout their lifetime.

Is Treatment Confidential?

Yes, treatment for substance use disorders is confidential. Healthcare treatment, in general, is covered under HIPAA, which is a federal law that protects people’s privacy around their healthcare records and keeps treatment information confidential.¹⁴ In addition, substance use treatment is protected even more, under special rules at the Federal level known as 42CFR.¹⁵ Providers who release information about your conditions, including substance use, can face severe penalties and fines.