Understanding Medication-Assisted Treatment
Medication-assisted treatment (MAT) is the use of FDA-approved medications in combination with behavioral therapies to treat substance use disorders. MAT is considered the gold standard for opioid use disorder treatment by the World Health Organization, National Institute on Drug Abuse, and Substance Abuse and Mental Health Services Administration. Research demonstrates that MAT reduces opioid use by 50 to 80 percent, decreases overdose mortality by 50 percent or more, reduces criminal activity and disease transmission, and improves social functioning and quality of life. Despite overwhelming evidence, only about 20 percent of Americans with opioid use disorder receive MAT, due to provider shortages, stigma, cost, and regulatory barriers.
MAT works by normalizing brain chemistry disrupted by chronic substance use, blocking the euphoric effects of drugs, relieving physiological cravings, and allowing the brain's reward system to gradually heal. Contrary to the misconception that MAT simply replaces one addiction with another, MAT medications (when prescribed at appropriate doses) do not produce euphoria or impairment. Instead, they stabilize brain function, allowing patients to engage effectively in behavioral therapy, rebuild relationships, maintain employment, and participate fully in recovery.
International MAT programs offer several advantages: cost savings of 60 to 75 percent, intensive medical supervision for optimal dose stabilization, integrated behavioral therapy delivered in an immersive treatment environment, and the therapeutic benefit of geographic separation from substance-using environments. Moodist Hospital provides comprehensive MAT programs with experienced addiction medicine physicians who follow evidence-based guidelines for medication selection, dosing, and duration.
MAT Medications in Detail
Buprenorphine formulations include sublingual tablets and films (Suboxone, Subutex), extended-release subcutaneous injection (Sublocade), and subdermal implant (Probuphine). Buprenorphine's partial agonist mechanism provides enough opioid receptor activation to prevent withdrawal and reduce cravings while having a ceiling effect that limits respiratory depression risk. Suboxone combines buprenorphine with naloxone to deter misuse. Sublocade provides monthly injections that eliminate daily dosing adherence concerns. International centers can initiate buprenorphine treatment and stabilize dosing during inpatient stays, with patients transitioning to home-based maintenance through local providers.
Naltrexone is available as oral tablets (daily) or extended-release intramuscular injection (Vivitrol, monthly). As an opioid antagonist, naltrexone completely blocks opioid receptors, preventing any effect from opioid use. Patients must be fully detoxified (opioid-free for 7-14 days) before starting naltrexone to avoid precipitated withdrawal. Vivitrol is particularly valuable for patients who prefer complete abstinence from all opioids, have concerns about buprenorphine diversion potential, or want the convenience and adherence assurance of monthly dosing. Moodist Hospital can administer Vivitrol injections as part of discharge planning, providing 30 days of opioid blockade for the vulnerable transition to home-based recovery.
MAT for alcohol use disorder includes naltrexone (same medication, different mechanism for alcohol), acamprosate, and disulfiram. Oral naltrexone reduces alcohol cravings and the rewarding effects of drinking. Acamprosate helps restore normal glutamate signaling disrupted by chronic alcohol use, reducing protracted withdrawal symptoms and supporting abstinence. Disulfiram creates an aversive reaction to alcohol by blocking alcohol metabolism, serving as a deterrent in motivated patients. These medications are integrated into comprehensive alcohol treatment programs at international centers.
- Buprenorphine (Suboxone) — partial agonist for opioid use disorder maintenance
- Sublocade — monthly buprenorphine injection for improved adherence
- Vivitrol — monthly naltrexone injection for opioid and alcohol use disorders
- Methadone — full agonist for severe opioid dependence
- Naltrexone (oral) — daily opioid/alcohol blocker for motivated patients
- Acamprosate — glutamate modulator for alcohol abstinence support
- Disulfiram — alcohol deterrent medication for motivated patients
- Lofexidine — non-opioid medication for opioid withdrawal management
Cost Comparison by Country
Medication-Assisted Treatment Cost Comparison 2025
| Treatment | USA Cost | Turkey Cost | Savings |
|---|---|---|---|
| MAT Assessment + Initiation | $1,000 - $3,000 | $300 - $700 | Up to 77% |
| Suboxone Stabilization (30 days inpatient) | $10,000 - $25,000 | $2,500 - $5,000 | Up to 75% |
| Vivitrol Injection (per dose) | $1,500 - $2,500 | $400 - $800 | Up to 68% |
| MAT + Behavioral Therapy (60 days) | $15,000 - $30,000 | $3,500 - $7,000 | Up to 77% |
| Methadone Stabilization (30 days) | $8,000 - $15,000 | $2,000 - $4,000 | Up to 73% |
| Sublocade Injection (per dose) | $1,800 - $3,000 | $500 - $1,000 | Up to 67% |
MAT should always be combined with behavioral therapy for optimal outcomes. Costs include medication, medical monitoring, and therapy. Long-term MAT may be needed for optimal recovery.
The cost advantage of MAT initiation abroad is particularly significant for patients who need supervised induction and stabilization. A 30-day inpatient MAT stabilization program in the US costs $10,000 to $25,000, while the same program at an international center costs $2,500 to $5,000. For patients transitioning from illicit opioid use to buprenorphine, the medical supervision and behavioral support available in an inpatient international setting provides the safest and most effective start to MAT.
Interested in medication-assisted treatment for addiction? Get free quotes from centers offering comprehensive MAT programs with experienced addiction medicine physicians.
Get Free QuoteTop MAT Program Centers
Moodist Hospital offers comprehensive MAT programs for both opioid and alcohol use disorders. The hospital's addiction medicine team follows evidence-based guidelines for medication selection, dosing, and integration with behavioral therapies. Programs include supervised induction and dose stabilization, individual and group therapy, psychiatric evaluation and treatment of co-occurring conditions, and thorough discharge planning with home-based MAT coordination.
Acıbadem Maslak Hospital, Memorial Şişli Hospital, and American Hospital Istanbul provide addiction medicine services with varying MAT capabilities. When selecting a center for MAT, verify the availability of your preferred medication, the presence of addiction medicine physicians (not just general psychiatrists), and the center's ability to coordinate with your home-based MAT provider for seamless continuity.
Long-Term MAT Management
Current evidence strongly supports long-term MAT maintenance rather than time-limited treatment. Studies consistently show that patients who remain on MAT for at least 12 months have significantly better outcomes than those who discontinue earlier, and many experts recommend indefinite maintenance for chronic, severe opioid use disorder. Premature discontinuation of MAT is the single strongest predictor of relapse, with relapse rates exceeding 80 percent within the first year of MAT cessation. The decision to taper MAT should be made carefully, only after sustained stability (typically 12-24 months), psychosocial stability, strong support systems, and patient readiness.
The transition from international MAT initiation to home-based maintenance is carefully coordinated. Before discharge, the treatment team identifies a local MAT provider, ensures sufficient medication supply for the transition period (typically 14-30 days), provides comprehensive documentation for the receiving provider, and establishes follow-up appointments. Many international centers offer telemedicine consultations during the first months to provide additional support and guidance during the critical transition period.
Starting MAT at Moodist Hospital was the best decision I ever made. The addiction medicine team stabilized me on Suboxone during a 30-day inpatient stay that included daily therapy and treatment for my depression. The cost was $4,500 — my US options were $18,000 or more. They coordinated my transition to a local MAT provider, and I have been on Suboxone and stable for two years. MAT gave me my life back.
Andrew C., MAT patient from the US
Frequently Asked Questions
Is MAT just replacing one drug with another?
No. This is a common misconception. MAT medications, when prescribed at appropriate doses, do not produce euphoria or impairment. They normalize brain chemistry, relieve cravings, and allow patients to function normally. MAT is analogous to insulin for diabetes — it is medication for a medical condition, not drug substitution. All major medical organizations endorse MAT as the standard of care for opioid use disorder.
How long will I need to take MAT medication?
Current evidence supports long-term MAT of at least 12 months, and many experts recommend indefinite maintenance for severe OUD. Premature discontinuation leads to relapse in over 80% of cases. If tapering is desired, it should be attempted only after sustained stability (12-24 months), gradual dose reduction over months, and with close medical supervision and support.
Can I start MAT abroad and continue it at home?
Yes, this is a common and effective approach. The international center stabilizes your dose and provides documentation for your local provider. Buprenorphine can be prescribed by certified providers in most countries. Vivitrol can be administered before discharge, providing 30 days of coverage. Coordinate with a local MAT provider before traveling to ensure seamless transition.
What if my local doctor does not support MAT?
Unfortunately, stigma against MAT persists among some healthcare providers. If your local physician does not support MAT, seek a provider who does — many addiction medicine specialists and certified MAT providers are available through directories like SAMHSA's treatment locator. Telemedicine MAT services have also expanded access significantly. Do not discontinue MAT due to provider attitudes — the evidence overwhelmingly supports its effectiveness.