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Medication-Assisted Treatment (MAT)

MAT was first introduced fifty years ago. This treatment effectively replaces illicit or prescription opioid use with long-acting opioids that provoke minimal exhilaration, such as buprenorphine or methadone (Nosyk, et al., 2013). Methadone is an opioid agonist, it suppresses cravings and eliminates the symptoms of withdrawal. Patients report to treatment centers or a physician’s office each morning to receive their dose of methadone. Only those patients who demonstrate stability in MAT and produce negative urine drug tests (UDS) can remain in treatment. Buprenorphine (Subutex) is a partial opioid agonist that is like methadone but has a ceiling effect that reduces abuse or overdose potential (Nosyk, et al., 2013). Buprenorphine and Naloxone (Suboxone) is a partial agonist that is combined with an opioid antagonist that hinders patients from injecting (IV use). Suboxone is available in pill form or films whereas Subutex is only available in pill form only. Patients may receive Buprenorphine at drug treatment centers or at a physician’s office.

Societal Concerns and Issues

1) Requirements of Physicians and Dispensing

a. Physicians and treatment centers must abide by with the regulations regarding controlled substances, including the specifications for documentation, storage and permissions as detailed below. They must also ensure that the proper medication is furnished to the right patient at the right dose at the right time. This should include:

i. assuring the legitimacy of the prescription

ii. identifying the patient (checking a recent photo if the Physician is uncertain about a client’s identity)

iii. observing the consumption of doses (methadone only) onsite

iv. educate patients on proper use of buprenorphine: place pill under tongue (no eating, drinking, talking, smoking, or chewing gum) until completely dissolved.

2) Overdose

a. Methadone can result in overdose or death if the dose is incorrectly dispensed; for example, a small discrepancy in measuring the volume of methadone would render a relatively large discrepancy and have disastrous consequences for the patient.

3) Diversion

a. Diversion is the selling, trading, or giving medication to another person. There is a substantial market for buprenorphine with prices generally around the $2.5 per milligram being reported. There are several public health issues related to diversion such as overdose, accidental ingestion by children, and the likelihood for causing opioid dependence in another person (Kathryn L. Hahn, 2011). The injection of buprenorphine (Subutex, Suboxone) may cause death or loss of limb. All cases of diversion should be reported immediately.

Future Implications

Discussions pertaining to addiction being a choice or disease continues to be a moralistic issue. The opioid crisis will not disappear on its own. MAT services will need to be more accessible for the millions of people with OUD. Opinions continue to support views that opioid addiction, given the right circumstances, can be treated effectively with MAT, when MAT enlists extensive services, such as individual and/or group counseling, and access to treatment for co-occurring disorders.



We Can Help

If you or a family member are addicted to Opioids (pain pills, dilaudid, or heroin); call us, The Expert Suboxone Doctor Orange Park. We are currently accepting new patients 904-999-9064


References

Kathryn L. Hahn, P. D. (2011). Strategies to Prevent Opioid Misuse, Abuse, and Diversion That May Also Reduce the Associated Costs. American Health & Drug Benefits, 4(2), 107-114. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106581/pdf/ahdb-04-107.pdf

Nosyk, B., Anglin, M. D., Brissette, S., Kerr, T., Marsh, D. C., Schackman, B. R., . . . Montaner, J. S. (2013, August). ANALYSIS & COMMENTARY: A Call For Evidence-Based Medical Treatment Of Opioid Dependence In The United States And Canada. Health Affairs, 32(8), 8. Retrieved from https://pdfs.semanticscholar.org/d6f9/2a1a9d1e2ba403c19e5dd1df9025d150f019.pdf

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