Medication assisted treatment (MAT) for substance use disorders at the Thelma Mcmillen Center for Alcohol and Drug Treatment.
Written by Dr. Donnie Watson
What is Medication Assisted Treatment (MAT) you ask? And why and how we utilize it at Thelma McMillen Intensive Outpatient Treatment Program?
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.