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MAT Overview

Medication Assisted Treatment (MAT)

Medication assisted treatment (MAT) is the use of pharmacological medications, in combination with counseling and behavioral therapies, to provide a ‘whole patient' approach to the treatment of substance use disorders. Research indicates that a combination of medication and behavioral therapies can successfully treat substance use disorders, and for some people struggling with addiction, MAT can help sustain recovery.
Check out the CIHS eSolutions
Medication Assisted Treatment: An Adjunct to Addictions Treatment



General RESOURCES

Expanding the Use of Medications to Treat Individuals with Substance Use Disorders outlines the lessons learned from a year-long collaborative with safety-net providers to explore the barriers and opportunities for communities to implement use of medications for addictions treatment. A companion Medication Assisted Treatment Implementation Checklist outlines the key questions to consider before engaging in efforts to increase access to medication assisted treatment for addictions.

SAMHSA's Opioid Overdose Prevention Toolkit
Equips communities and local governments with material to develop policies and practices to help prevent opioid-related overdoses and deaths. It also addresses issues for first responders, treatment providers, and those recovering from opioid overdose.

Published by the American Society of Addiction Medicine, the Medicaid Benefits for the Treatment of Opioid Use Disorder Nationwide displays state's Medicaid fee-for-service benefit coverage for medications approved to treat opioid dependence.

The Centers for Medicare & Medicaid Services (CMS) released an Informational Bulletin highlighting the use of FDA-approved medications in combination with evidence-based behavioral therapies to help persons with mental health and substance use disorders recover in a safe and cost-effective manner. The bulletin provides background information about medication assisted treatment (MAT), examples of state-based initiatives, and useful resources to help ensure proper delivery of these services.

The American Psychiatric Association will conduct several webinars in 2014 on behalf of SAMHSA' Providers’ Clinical Support System for Medication Assisted Treatment (PCSSMAT). SAMHSA’ PCSSMAT national training and mentoring project was developed in response to the prescription opioid misuse epidemic and the availability of newer pharmacotherapies to address opioid dependence. The overarching goal of PCSS-MAT is to make available the most effective medication-assisted treatments to serve patients in a variety of settings, including primary care, psychiatric care, and pain management settings. Upcoming webinar topics include pain management, the psychology of AA, and treatment options. 

Advancing Access to Addiction Medications: Implications for Opioid Addiction Treatment
Effective medications are available to treat opioid dependence, but they are underutilized (See Knudsen et al., 2011). Economic evaluations are useful in helping decision makers determine whether medications for the treatment of opioid disorders might add sufficient value to justify their costs and could provide evidence to support the more widespread use of medications for opioid dependence. As such, the objective of this review was to gather,evaluate, and summarize empirical economic evaluations of medications (e.g., methadone,buprenorphine and naltrexone) for the treatment of opioid dependence.

Buprenorphine/Naloxone and Methadone Maintenance Treatment Outcomes for Opioid Analgesic, Heroin, and Combined Users: Findings From Starting Treatment With Agonist Replacement Therapies (START) is a recent study that looks at treatment outcomes versus type of treatment medication used. 

Financial Factors and the Implementation of Medications for Treating Opioid Use Disorders examines the relationships between organizational factors and the program-level implementation of MAT, with attention paid to specific sources of funding, organizational structure, and workforce resources.

The Training Tool for Residential Substance Abuse Treatment: Medication Assisted Treatment for Offender Populations is an excellent guide based on evidence based practices. It was written by Nikki Miller, who is a senior program associate in the Advocates for Human Potential with a number of partners, including Treatment Alternatives for Safe Communities (TASC).

SAMHSA's General Principles for the Use of Pharmacological Agents To Treat Individuals With Co-Occurring Mental and Substance Use Disorders provides general principles to assist in the planning, delivery, and evaluation of pharmacologic approaches to support the recovery of individuals with co-occurring mental and substance use disorders.

The ATTC's Medication-Assisted Treatment with Special Populations online training, developed for both non-physician treatment providers and physicians, is designed to enhance professionals' knowledge and skills related to reaching and educating the special populations about MAT and increasing the use of MAT among minority populations.

SAMHSA’s Advisory: An Introduction to Extended-Release Injectable Naltrexone for the Treatment of People with Opioid Dependence overviews extended-release injectable naltrexone (Vivitrol), a treatment for people with opioid dependence, and discusses how it differs from other medication-assisted treatments, safety concerns, and consumers most likely to benefit from this treatment.

*New* A compilation of essays by individuals supported by Medication-Assisted Treatment in long-term recovery developed in partnership with Faces & Voices of Recovery and the National Alliance for Medication Assisted Recovery.

The Rx Database is designed as a "desk-top reference" of medications commonly used to treat individuals with alcohol, drug, and mental health conditions. This searchable database offers is intended to provide a basic understanding of medication dose, frequency, side effects, emergency conditions, abuse potential, cautions, and considerations for pregnant women.  

Medication-Assisted Treatment for Opioid Addiction: Friends and Families is a useful resources developed by SAMHSA for friends and families of individuals struggling with addiction.

SAMHSA’s Treatment Improvement Protocol (TIP) 40: Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction provides information that physicians can use to make practical and informed decisions about the use of buprenorphine to treat opioid addiction.

SAMHSA’s TIP 43: Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs discusses MAT use in addiction treatment programs for opioid dependence.

SAMHSA’s TIP 49: Incorporating Alcohol Pharmacotherapies into Medical Practice provides guidance on implementing alcohol medications into routine medical practice.

The Addiction Technology Transfer Center (ATTC) Network is a SAMHSA-funded nationwide network of centers that provides training and technical assistance to help enhance the knowledge, skills, and abilities of the addiction treatment workforce, through the dissemination of evidence based practices. The ATTC Network was recently awarded a supplemental grant, Work force development to increase medication-assisted treatment Services among Minority Populations to increase awareness, provide education, and promote access to MAT for the four identified racial and ethnic populations: (1) African American; (2) American Indian/Alaskan Native; (3) Hispanic/Latino (a): and (4)  Asian, Native Hawaiian and other Pacific Islander. The specific foal for this initiative is to develop a training program.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) is the lead NIH agency on alcohol-related disorders and research for the treatment of alcoholism.

The National Institute on Drug Abuse (NIDA) goal is to bring the power of science to bear on addiction by supporting and conducting research and ensuring its rapid and effective dissemination and use to significantly improve prevention and treatment and to inform policy related to drug abuse.

SAMHSA’s Division of Pharmacotherapies (DPT) manages the day-to-day regulatory oversight activities necessary to implement SAMHSA regulation 42 CFR Part 8 on the use of FDA-approved opioid agonist medications (methadone, LAAM, and buprenorphine) for addiction treatment. These activities include supporting the certification and accreditation of over 1,000 opioid treatment programs (i.e., methadone clinics) that collectively treat over 200,000 patients annually. DPT also supports the Drug Addiction Treatment Act of 2000 (DATA 2000), which expands the clinical context of medication-assisted opioid addiction treatment by allowing qualified physicians to dispense or prescribe specifically approved Schedule III, IV, and V narcotic medications for the treatment of opioid addiction in treatment settings other than the traditional opioid treatment program.

Managing Opioid Abuse, Dependence, and Addiction in a Primary Care Setting, a presentation by Jean J. Bonhomme MD, MPH, assistant professor, Morehouse School of Medicine’s Department of Psychiatry, provides an introduction to opioid abuse for primary care professionals.

RESOURCES ON MAT IMPLEMENTATION

Financial Factors and the Implementation of Medications of Addiction Treatment examines relationships between organizational factors and the program-level implementation of MAT, with attention paid to specific sources of funding, organizational structure, and workforce resources.

Helpful Resources to Address Discrimination Against People in Medication-Assisted Treatment provides useful resources for educating employers, courts and others about Medication Assisted Treatment, including why methadone and buprenorphine do not impair physical or mental functioning when provided to individuals stabilized on the appropriate dose.

Getting Started with Medication-Assisted Treatment with Lessons from Advancing Recovery provides information and guidance on how to implement MAT into a drug treatment program. This toolkit shares lessons that emerged from the efforts of several Robert Wood Johnson Advancing Recovery project grantees to establish MAT programs in their organizations

RESOURCES FOR PHYSICIANS

Prescribers’ Clinical Support System for Opioid Therapies (PCSS-O) is a collaborative project that includes: American Academy of Addiction Psychiatry, American Dental Association, American Medical Association, American Osteopathic Academy of Addiction Medicine, American Psychiatric Association, American Society for Pain Management Nursing, and International Nurses Society on Addictions.These organizations will provide training and education on the safe and effective prescribing of opioid medications in the treatment of pain and/or opioid addiction. The focus of this project is to reach prescribers and/or prescribers-in-training from diverse healthcare professions including physicians, nurses, dentists, physician assistants, and pharmacists to offer free, accessible, evidence-based trainings.

The American Society of Addiction Medicine  represents nearly 3,000 physicians dedicated to increasing access and improving quality of addiction treatment, educating physicians and the public, supporting research and prevention, and promoting the appropriate role of physicians in the care of patients with addictions.

American Association of Addiction Psychiatry is an international organization with approximately 1,000 professional members that educates, influences, and encourages excellence in practice, policy, and prevention for the field of addiction psychiatry. 

Call Our Helpline: 202-268-7457

Medication Assisted Treatment (MAT)

Medication assisted treatment (MAT) is the use of pharmacological medications, in combination with counseling and behavioral therapies, to provide a ‘whole patient' approach to the treatment of substance use disorders. Research indicates that a combination of medication and behavioral therapies can successfully treat substance use disorders, and for some people struggling with addiction, MAT can help sustain recovery.
Check out the CIHS eSolutions
Medication Assisted Treatment: An Adjunct to Addictions Treatment



General RESOURCES

Expanding the Use of Medications to Treat Individuals with Substance Use Disorders outlines the lessons learned from a year-long collaborative with safety-net providers to explore the barriers and opportunities for communities to implement use of medications for addictions treatment. A companion Medication Assisted Treatment Implementation Checklist outlines the key questions to consider before engaging in efforts to increase access to medication assisted treatment for addictions.

SAMHSA's Opioid Overdose Prevention Toolkit
Equips communities and local governments with material to develop policies and practices to help prevent opioid-related overdoses and deaths. It also addresses issues for first responders, treatment providers, and those recovering from opioid overdose.

Published by the American Society of Addiction Medicine, the Medicaid Benefits for the Treatment of Opioid Use Disorder Nationwide displays state's Medicaid fee-for-service benefit coverage for medications approved to treat opioid dependence.

The Centers for Medicare & Medicaid Services (CMS) released an Informational Bulletin highlighting the use of FDA-approved medications in combination with evidence-based behavioral therapies to help persons with mental health and substance use disorders recover in a safe and cost-effective manner. The bulletin provides background information about medication assisted treatment (MAT), examples of state-based initiatives, and useful resources to help ensure proper delivery of these services.

The American Psychiatric Association will conduct several webinars in 2014 on behalf of SAMHSA' Providers’ Clinical Support System for Medication Assisted Treatment (PCSSMAT). SAMHSA’ PCSSMAT national training and mentoring project was developed in response to the prescription opioid misuse epidemic and the availability of newer pharmacotherapies to address opioid dependence. The overarching goal of PCSS-MAT is to make available the most effective medication-assisted treatments to serve patients in a variety of settings, including primary care, psychiatric care, and pain management settings. Upcoming webinar topics include pain management, the psychology of AA, and treatment options. 

Advancing Access to Addiction Medications: Implications for Opioid Addiction Treatment
Effective medications are available to treat opioid dependence, but they are underutilized (See Knudsen et al., 2011). Economic evaluations are useful in helping decision makers determine whether medications for the treatment of opioid disorders might add sufficient value to justify their costs and could provide evidence to support the more widespread use of medications for opioid dependence. As such, the objective of this review was to gather,evaluate, and summarize empirical economic evaluations of medications (e.g., methadone,buprenorphine and naltrexone) for the treatment of opioid dependence.

Buprenorphine/Naloxone and Methadone Maintenance Treatment Outcomes for Opioid Analgesic, Heroin, and Combined Users: Findings From Starting Treatment With Agonist Replacement Therapies (START) is a recent study that looks at treatment outcomes versus type of treatment medication used. 

Financial Factors and the Implementation of Medications for Treating Opioid Use Disorders examines the relationships between organizational factors and the program-level implementation of MAT, with attention paid to specific sources of funding, organizational structure, and workforce resources.

The Training Tool for Residential Substance Abuse Treatment: Medication Assisted Treatment for Offender Populations is an excellent guide based on evidence based practices. It was written by Nikki Miller, who is a senior program associate in the Advocates for Human Potential with a number of partners, including Treatment Alternatives for Safe Communities (TASC).

SAMHSA's General Principles for the Use of Pharmacological Agents To Treat Individuals With Co-Occurring Mental and Substance Use Disorders provides general principles to assist in the planning, delivery, and evaluation of pharmacologic approaches to support the recovery of individuals with co-occurring mental and substance use disorders.

The ATTC's Medication-Assisted Treatment with Special Populations online training, developed for both non-physician treatment providers and physicians, is designed to enhance professionals' knowledge and skills related to reaching and educating the special populations about MAT and increasing the use of MAT among minority populations.

SAMHSA’s Advisory: An Introduction to Extended-Release Injectable Naltrexone for the Treatment of People with Opioid Dependence overviews extended-release injectable naltrexone (Vivitrol), a treatment for people with opioid dependence, and discusses how it differs from other medication-assisted treatments, safety concerns, and consumers most likely to benefit from this treatment.

*New* A compilation of essays by individuals supported by Medication-Assisted Treatment in long-term recovery developed in partnership with Faces & Voices of Recovery and the National Alliance for Medication Assisted Recovery.

The Rx Database is designed as a "desk-top reference" of medications commonly used to treat individuals with alcohol, drug, and mental health conditions. This searchable database offers is intended to provide a basic understanding of medication dose, frequency, side effects, emergency conditions, abuse potential, cautions, and considerations for pregnant women.  

Medication-Assisted Treatment for Opioid Addiction: Friends and Families is a useful resources developed by SAMHSA for friends and families of individuals struggling with addiction.

SAMHSA’s Treatment Improvement Protocol (TIP) 40: Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction provides information that physicians can use to make practical and informed decisions about the use of buprenorphine to treat opioid addiction.

SAMHSA’s TIP 43: Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs discusses MAT use in addiction treatment programs for opioid dependence.

SAMHSA’s TIP 49: Incorporating Alcohol Pharmacotherapies into Medical Practice provides guidance on implementing alcohol medications into routine medical practice.

The Addiction Technology Transfer Center (ATTC) Network is a SAMHSA-funded nationwide network of centers that provides training and technical assistance to help enhance the knowledge, skills, and abilities of the addiction treatment workforce, through the dissemination of evidence based practices. The ATTC Network was recently awarded a supplemental grant, Work force development to increase medication-assisted treatment Services among Minority Populations to increase awareness, provide education, and promote access to MAT for the four identified racial and ethnic populations: (1) African American; (2) American Indian/Alaskan Native; (3) Hispanic/Latino (a): and (4)  Asian, Native Hawaiian and other Pacific Islander. The specific foal for this initiative is to develop a training program.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) is the lead NIH agency on alcohol-related disorders and research for the treatment of alcoholism.

The National Institute on Drug Abuse (NIDA) goal is to bring the power of science to bear on addiction by supporting and conducting research and ensuring its rapid and effective dissemination and use to significantly improve prevention and treatment and to inform policy related to drug abuse.

SAMHSA’s Division of Pharmacotherapies (DPT) manages the day-to-day regulatory oversight activities necessary to implement SAMHSA regulation 42 CFR Part 8 on the use of FDA-approved opioid agonist medications (methadone, LAAM, and buprenorphine) for addiction treatment. These activities include supporting the certification and accreditation of over 1,000 opioid treatment programs (i.e., methadone clinics) that collectively treat over 200,000 patients annually. DPT also supports the Drug Addiction Treatment Act of 2000 (DATA 2000), which expands the clinical context of medication-assisted opioid addiction treatment by allowing qualified physicians to dispense or prescribe specifically approved Schedule III, IV, and V narcotic medications for the treatment of opioid addiction in treatment settings other than the traditional opioid treatment program.

Managing Opioid Abuse, Dependence, and Addiction in a Primary Care Setting, a presentation by Jean J. Bonhomme MD, MPH, assistant professor, Morehouse School of Medicine’s Department of Psychiatry, provides an introduction to opioid abuse for primary care professionals.

RESOURCES ON MAT IMPLEMENTATION

Financial Factors and the Implementation of Medications of Addiction Treatment examines relationships between organizational factors and the program-level implementation of MAT, with attention paid to specific sources of funding, organizational structure, and workforce resources.

Helpful Resources to Address Discrimination Against People in Medication-Assisted Treatment provides useful resources for educating employers, courts and others about Medication Assisted Treatment, including why methadone and buprenorphine do not impair physical or mental functioning when provided to individuals stabilized on the appropriate dose.

Getting Started with Medication-Assisted Treatment with Lessons from Advancing Recovery provides information and guidance on how to implement MAT into a drug treatment program. This toolkit shares lessons that emerged from the efforts of several Robert Wood Johnson Advancing Recovery project grantees to establish MAT programs in their organizations

RESOURCES FOR PHYSICIANS

Prescribers’ Clinical Support System for Opioid Therapies (PCSS-O) is a collaborative project that includes: American Academy of Addiction Psychiatry, American Dental Association, American Medical Association, American Osteopathic Academy of Addiction Medicine, American Psychiatric Association, American Society for Pain Management Nursing, and International Nurses Society on Addictions.These organizations will provide training and education on the safe and effective prescribing of opioid medications in the treatment of pain and/or opioid addiction. The focus of this project is to reach prescribers and/or prescribers-in-training from diverse healthcare professions including physicians, nurses, dentists, physician assistants, and pharmacists to offer free, accessible, evidence-based trainings.

The American Society of Addiction Medicine  represents nearly 3,000 physicians dedicated to increasing access and improving quality of addiction treatment, educating physicians and the public, supporting research and prevention, and promoting the appropriate role of physicians in the care of patients with addictions.

American Association of Addiction Psychiatry is an international organization with approximately 1,000 professional members that educates, influences, and encourages excellence in practice, policy, and prevention for the field of addiction psychiatry. 

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