Here’s why, MAT has increasingly become part of the cadre of tools
used to treat Substance Use Disorders (SUDs) due to advances in medical
research and practice, and due to the increasing rates of addiction problems
in the United States, particularly opioid dependence. Medication Assisted
Treatment (MAT) is the use of medications, in combination with counseling
and behavioral therapies, to provide a “whole-patient” approach
to the treatment of substance use disorders because research demonstrates
that this combination can successfully treat and maintain recovery (Substance
Abuse and Mental Health Services Administration (SAMHSA, 2015). While
MAT is primarily used to treat opioids such as heroin and other narcotic
addictions, dependence on prescription medications, it can be used for
alcohol use disorders. It is important to note that one common misconception
of MAT is that it substitutes one for another. To the contrary, these
medications safely (under medical supervision) relieve physical withdrawals
and psychological cravings for the patient that can frequently hamper
recovery efforts for the patient.
To determine the appropriateness of MAT for a patient, the Thelma McMillen
Center begins with a comprehensive bio-psycho-social consultation to assess
the feasibility of MAT by reviewing their use history, overall physical
health and psychological health, verifying whether under care of a physician,
their willingness to try this approach and review of other medications
the patient currently uses. If a patient wants MAT as part of their treatment
program, the Program Director and/ or Executive Director determine if
the patient requires an inpatient program to safely detox from the substances,
or if ambulatory detoxification is warranted based on patient’s
report of the severity of withdrawal symptoms. If inpatient detoxification
is indicated, we initiate the process of inpatient or residential care.
The patient can then return and begin our standard treatment with MAT
as an adjunct. If ambulatory detox is feasible, a call is made to one
of the several physicians we work with to coordinate the MAT treatment
under the care of the physician. There are a number of MATs for opioids
(Naltrexone, Buprenorphine or combination of the two, Probuphine (longer
acting implant) and alcohol dependence (Disulfiram, Acamprosate and Naltrexone).
The prescribing physician in consultation with the patient determines
the appropriate medicines.
Once the patient enters the Intensive Outpatient Program, in addition to
the core elements of the program, those suffering from opioid problems
also participate in in an opioid process and education group that is only
open to them. We use this approach as an “add-on” for opioid
users because we have found that opioid users have unique needs in terms
of triggers, use patterns and withdrawal symptoms. Importantly, we also
maintain bi-weekly contact with their MAT provider throughout treatment
to ensure coordination of care. If you or your loved one would like to
know more about the use of Medication Assisted Treatment at the Thelma
McMillen Center, kindly contact us and we would be glad to discuss it with you.