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    Medication Assisted Treatment Program for Opioid Addiction

    Deaconess Cross Pointe 11/22/2017
    Discussions about the “opioid crisis” are everywhere. You may have heard stories on the news, read articles posted on social media, or had first-hand experience with a friend or loved one. I want to take this opportunity to tell you about a really important program that helps people addicted to opioids (heroin, prescription pain pills, etc.) come off drugs and move into recovery.
    The program is called Medication Assisted Treatment (MAT). It is the use of medications, with counseling and behavioral therapies, to treat substance use disorders and prevent opioid overdose. MAT is primarily used for the treatment of addiction to opioids such as heroin and prescription pain relievers that contain opiates.
    We began offering this program at Deaconess Cross Pointe in May 2017 after months of research indicated the MAT program provided the highest rates of success.

    We accept most private insurance, Medicare, Medicaid and HIP.  This is significant, because most other MAT programs are cash/pre-pay only. There are some co-pays involved, such as for office visits, therapy and the medication. However, it usually adds up to being far less expensive than the addiction itself.  All insurance is subject to approval based on medical necessity; our outpatient office staff can answer insurance questions.
    What does MAT look like for the patient?
    The general process for patients participating in the MAT program goes like this:
    A potential MAT patient is screened and assessed by a Licensed Clinical Social Worker and a Psychiatrist.
    After initial assessment and if the patient is diagnosed with an opioid use disorder, appropriate medication/dosage is given to help the patient reduce withdrawal symptoms as they stop using the opioid.
    Balancing that medication is a first priority, as the patient needs to have manageable symptoms to be able to progress through the program.
    Once a dosage is found that reduces cravings and eliminates withdrawal symptoms, the true therapy program can begin. The patient must agree to participate in group and individual counseling as well as attend twelve step meetings. 
    M = Medication
    The “M” in MAT stands for medication. At Deaconess Cross Pointe, the primary medications used as part of the treatment program are buprenorphine and naltrexone.
    Buprenorphine belongs to a class of drugs called “opiate agonists” and is considered a narcotic. Like heroin and other drugs created from morphine, buprenorphine attaches to receptors in the brain to reduce pain and create euphoria. Unlike opioids, the receptors don’t make a perfect fit with the buprenorphine. As a result, the receptor is tricked into thinking it has been satisfied with opioids without producing strong feelings of euphoria, and without causing significant respiratory depression. This, in turn, prevents that receptor from fully joining with opioids; therefore if the patient uses heroin or painkillers, they are unlikely to experience additional effects.
    The abuse potential and risk for overdose with buprenorphine is lower than that of methadone. Buprenorphine also tends to stay with the receptors, blocking them, much longer than opioids do. This stickiness is what makes buprenorphine last so long, up to 3 days.
    Naltrexone also belongs to the opiate antagonists class of drugs. It works in the brain to prevent opiate effects (e.g., feelings of well-being, pain relief) and decreases the desire to take opioids.
    Naltrexone is also used to treat alcohol abuse. It can help people drink less alcohol or stop drinking altogether when used with a treatment program that includes counseling, support, and lifestyle modifications.
    Some treatment clinics use the drug methadone as part of their medication assisted therapy. We do not.
    Methadone is a schedule 2 drug that can only be prescribed (for treating addiction, not pain) by a physician registered through the Drug Enforcement Administration as a Narcotic Treatment Program. It has a fairly high potential for abuse and the chance of fatal overdose is significant if not taken as prescribed. Methadone maintenance therapy requires daily visits to a clinic for dosing.
    T = Therapy
    In the MAT program, the “T” component, behavioral therapy and counseling, is just as important as the medication part.

    Therapy consists of either group therapy as part of the Intensive Outpatient Program (IOP) or the Matrix program. In both of these programs, the patient with the addiction is in a group with other people who are battling similar addictions. 

    The IOP includes group therapy 3x/week (evenings) for six weeks. The Matrix program group therapy is 2x/week during the day, and lasts 10 weeks. In both programs, participants must attend 12 step support group meetings (such as NA or AA) in addition to the group therapy. 

    Individual therapy is available as well for those patients who want to participate and we strongly encourage family involvement and participation in educational programs we offer.
    Important Notes
    MAT is a complete abstinence program. We help people stop all types of substance use and abuse. We require regular urine/drug screening and we count pills from the prescriptions given.  Because of the intensive nature of this program, it’s not for everyone.

    How do I learn more or begin the MAT program?
    Interested individuals may get more information or schedule an appointment by contacting:
    Care Team at Deaconess Cross Pointe:   Phone: 812 476-7200

    Or visit the Deaconess Cross Pointe Drug & Alcohol Treatment Program webpage. 
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