Medication assisted treatment for opioid use disorder
More than 2.5 million Americans are in need of assistance treating opioid use disorder. According to the American Society of Addiction Medicine, “Of the 20.5 million Americans 12 or older that had a substance use disorder in 2015, two million had a substance use disorder involving prescription pain relievers and 591,000 had a substance use disorder involving heroin.”
One evidence-based treatment option available is medication assisted treatment (MAT). MAT is meant to be provided along with counseling and other services that help patients reduce stressors that can lead to active addiction. Programs like PATHways in the UK College of Nursing are an example of that. In addition to MAT, these types of programs offer counseling, peer support and other health care services.
The type of medication commonly used for opioid use disorder is called buprenorphine. It is provided to patients at intervals that are determined by their doctor. The medication can be delivered as a film placed under the tongue or a pill, but research is
being conducted to find alternative delivery routes such as implants or injections.
To provide MAT, physicians must meet several requirements set by the Drug Enforcement Agency and Substance Abuse and Mental Health Services Administration. Prescribers must be licensed under state law, and they must register with the DEA and complete training and/or certification. Providers must all be able to refer patients to counseling or other services.
There are also restrictions on how many patients a doctor can treat using MAT. During the first year of securing the DEA waiver, providers can treat up to 30 patients. After the first year, they can apply to treat up to 100 patients; after the second year, they can apply to treat up to 275 patients.
The opioid epidemic has impacted every corner of the United States, especially rural communities that have difficulty accessing medical care, but there are options available for helping those in active addiction enter recovery.
Dr. Michael Kindred is an assistant professor in the University of Kentucky College of Medicine.