Medication Assisted Treatment

Medication Assisted Treatment 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.

Research shows that when treating substance-use disorders, a combination of medication and behavioral therapies is most successful. Medication assisted treatment (MAT) is clinically driven with a focus on individualized patient care.

When prescribed and monitored properly, MATs have proved effective in helping patients recover. Moreover, they have been shown to be safe and cost-effective and to reduce the risk of overdose.

Medication Assisted Treatment Group MeetingMedication Assisted Treatment Group Meeting

Program goals:

  • To treat opioid dependence
  • To prevent relapse to opioid dependence, after detoxification
  • To effectively treat individuals through personal assessment, evidence-based counseling, and Suboxone or Naltrexone oral prescriptions, Methadone, or Vivitrol injections.
  • To counsel individuals on the risks and benefits of the program

Phases of treatment:

Admission/Induction

A licensed professional administers the following:

  • Global Assessment Functioning (GAF)
  • Addiction Severity Index (ASI) or Brief Addiction Monitor (BAM)
  • Clinical Opiate Withdrawal Scale (COWS)

First appointment with medical doctor—client will be in withdrawal. Doctor discusses administration of medication and follow-up appointments.

Stabilization Period

Phase I

  • Meet with medical doctor 1x per week
  • Meet with the agency’s MAT group and attend Intensive Outpatient Counseling (IOP) three times a week, or, if employed, attend Substance Abuse Treatment (SATP) sessions weekly.
  • Submit urine for drug screening: 1x per week, random, must test within 24 hours of call.
  • Outside support meetings (Alcoholics Anonymous, Narcotics Anonymous)
  • Obtain qualified sponsor
  • Individual counseling is available but not required
  • Family or Support Therapy with client present (2 sessions)
  • Medication: Decrease initial dose by 25%
  • Education/Employment — look for employment or educational opportunities
  • Legal: Satisfy all pending legal issues, incur no new legal charges
  • Maintain 90 days of continuous sobriety
  • Take medication as prescribed, with random pill counts

Phase II

  • Meet with medical doctor once every two weeks
  • Meet with MAT group once every two weeks
  • Drug screens: 2x per month, random, must test within 24 hours of call.
  • Outside support meetings 2x per week
  • Work 12 steps with sponsor
  • Individual counseling available, but not required
  • Family or Support therapy with client present, 2 sessions minimum
  • Medication: Decrease initial dosage by 50%
  • Education/Employment: Look for employment
  • Housing: Look for stable housing
  • Legal: Satisfy all pending legal issues and incur no new legal charges
  • Maintain one year of continuous sobriety
  • Take medication as prescribed, with random pill counts

Phase III

  • Meet with doctor 1x per month
  • Meet with MAT group 1x per month
  • Drug screens: Monthly, random, must test within 24 hours of call
  • Outside support meetings 2x per week
  • Continue to work steps with sponsor
  • Individual counseling required 1x per month for the first 6 months of Phase III
  • Family or Support therapy with client present — as needed
  • Medication: Decrease when ready
  • Employment: Must be gainfully employed or attending college/trade school
  • Housing: Must maintain stable housing
  • Legal: No new legal charges
  • Maintain sobriety
  • Take medication as prescribed, with random pill counts

Strikes

Four strikes = suspension. A client will receive strikes for the following:

  • Admission of drug or alcohol use
  • Not attending group
  • Not attending the required number of AA or NA meetings and submitting signed proof of attendance paperwork
  • Failure to submit urine for screening

Program suspension

30-day suspension, tapering dose is prescribed, for:

  • Lying: Claiming not to have used any drugs, but testing positive for drugs in urine drug screens
  • Pill count not accurate
  • Diverting medication
  • OARS indicates unreported opiate or other use/drug seeking behavior
  • Legal charges involving alcohol or drug use
  • Repeated failure to attend appointments with doctor
  • Inability to pay for medication and/or treatment

Eligibility

Eligibility for opioid treatment is determined by a mandatory clinical/medical assessment, which is conducted as part of the admission process.

Fees are assessed on a sliding scale, and Medicaid and most insurances are accepted