MEDICATION ASSISTED TREATMENT (MAT)
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Medication-assisted treatment (MAT) is the use of medications in combination with counseling and behavioral therapies for the treatment of substance use disorders. For those with an opioid use disorder (OUD), medication addresses the physical difficulties that one experiences when they stop taking opioids. MAT can help to reestablish normal brain function, reduce substance cravings and prevent relapse. The longer in treatment, the more the individual will be able to manage their dependency and move toward recovery.
Receiving Medication Assisted Treatment (MAT) with Buprenorphine (or Suboxone) Medication assisted treatment (MAT) with buprenorphine is a safe and effective method to help people with an opioid use disorder stop using prescription pain medications, heroin, and other opioids.
Treatment, not Substitution
Because methadone and buprenorphine are opioids, some people believe that treating addiction with these drugs simply substitutes one substance for another. Evidence-based treatment has proven that when patients take these medications as prescribed, they are more likely to maintain employment, avoid criminal behavior, and reduce their exposure to HIV by injection or substance-related high-risk sexual behaviors. They are also more likely to engage in counseling and other behavioral interventions that improve their recovery.
Methadone
Methadone is a long-acting synthetic opioid agonist medication that can prevent withdrawal symptoms and reduce craving in individuals with opioid-dependence. It can also block the euphoric effects of illicit opioids. It has a long history of use in treatment of opioid dependence and is taken orally.
Buprenorphine
Buprenorphine is a synthetic opioid medication that acts as a partial agonist at opioid receptors, but does not produce the euphoria and sedation caused by heroin or other opioids. Buprenorphine is able to reduce or eliminate withdrawal symptoms associated with opioid dependence and carries a low risk of overdose. Buprenorphine is currently available in two forms that are taken sublingually (dissolves under the tongue) and subcutaneous (injection): (1) a pure form of the substance and (2) a more commonly prescribed formulation called Suboxone, which combines buprenorphine with the substance naloxone, an antagonist (or blocker) at opioid receptors.
Naltrexone
Naltrexone is a synthetic opioid antagonist that blocks opioids from binding to the receptors and prevents the euphoric and sedating effects. Naltrexone itself has no subjective effects following detoxification and has no potential for abuse. Individuals should not use naltrexone if they are taking an opiate as they could experience sudden withdrawal symptoms.
Suboxone
Suboxone is an oral medication approved for office-based treatment of opioid use disorder. Suboxone blocks the effects of other opioids. Suboxone is composed of two medications: Buprenorphine and Naloxone. Buprenorphine offers several benefits to people for whom treatment in a methadone clinic is not preferred or is less convenient. Naloxone has poor absorption and is added in order to prevent the misuse of the medication. Treatment with Suboxone has been shown to be safe and effective. Suboxone is an important part of medication assisted treatment.
PHASES OF MEDICAL ASSISTED TREATMENT
There are three main phases of MAT:
1. Induction (first 1-2 days)
2. Stabilization (several weeks)
3. Maintenance (as long as it takes).
Patients who agree to participate in the Medication Assisted Treatment (MAT) Program at this practice must adhere to the policies and procedure of the program. Failure to adhere to the rules will result in dismissal from the program. Patients will work closely with the MAT provider to achieve their goals.
WHAT TO EXPECT
When starting an Opioid Abuse Treatment Program;
The first step of the MAT Program is to discuss treatment options with your provider. During this appointment, you learn about the pros and cons of medication as well as treatment expectations. You can review the Treatment Agreement and the Consent Form as part of this decision-making process.
Prior to starting treatment, you will have an MAT Overview Appointment. You will receive a physical exam and lab tests. Your MAT health care team will review instructions for Induction and determine a follow-up plan with you for Stabilization and Maintenance. You may be asked to provide urine, hair, and blood sample or mouth swab at any time during the treatment process. You may be referred to supplementary programs, e.g., counseling, physical therapy. Induction refers to the first 1-3 days of treatment. You will schedule an appointment for Induction.
Prior to that, you will stop using opioids from 16 hours to 48 hours at home or an inpatient location.
You will need to honestly report opioid and other drugs use to your MAT provider. This information will help determine the timing of your first dose.
You will be expected to arrive at your Induction appointment in a moderate state of withdrawal. A member of your MAT health care team will assess opioid withdrawal symptoms. This is vital for medication to be effective. Precipitated withdrawal can occur if you are not in moderate withdrawal. You can expect to feel better within 30 – 45 minutes of your first dose. The MAT provider will give additional doses during the induction to find the appropriate regular dose for you.
It is important to communicate with your provider and his/her staff how you are feeling. Induction lasts 1-3 days. You will maintain communication with your provider and care team during this time, either through phone calls or in-person visits. Before you leave the office on Induction Day 1, the MAT provider will likely give you a prescription that will last until your next appointment. Appointments will be made coinciding with refills.
The MAT care team will require you to come for follow up visits. The effectiveness and safety of your current dose will be assessed at these visits. You will be asked to provide sample for drug screening – for your safety. Failure to provide drug sample may result in dismissal from the program.
The second phase in treatment is called Stabilization. This phase may include continuing to find a dose that works for you. You will be asked to notify your provider or his/her staff if at any time you experience triggers or cravings. You will also begin working on treatment goals.
After achieving your treatment goals and feeling confident with progress made, your provider may decrease your dose preparing you for the next phase in treatment. During Stabilization, your MAT provider may refer you to counseling or other supplementary programs, if recommended. In the third phase, called Maintenance, the MAT provider will monitor your progress. There is no set timeline for how long you will continue treatment. You and your care team will decide when the time is right for you. Research recommends 12-18 months of treatment.
Some people receive treatment for longer. When the time comes, your dose will be tapered slowly, minimizing withdrawal symptoms.
Finally and most important, if you feel at any time you’re at risk of relapse, notify your MAT provider or his/her staff right away. Your MAT treatment team can continue the maintenance if necessary.
If you are battling substance use disorder or addiction to Opioids , contact us today.
You can begin medication assisted therapy with Suboxone treatment at our clinic.
Complete the intake forms and email us at info@yourtotalwellnessclinic.com or call 301-494-1006 to schedule an appointment and get started on your journey to freedom.
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