Partner Perspectives: Where Medication-assisted Treatment and Whole-person Care Meet

In recent research, the Centers for Disease Control and Prevention (CDC) found that 75% of the roughly 107,000 drug overdoses in the U.S. involved an opioid. What’s more, the number of opioid overdoses in 2022 was six times that of 1999.

Fortunately, over the last two decades, it has become evident that medication-assisted treatment (MAT) positively aids patients living with opioid use disorder (OUD), serving as a vital lifeline for more than 2 million people living in the U.S. In this article, we provide an overview of the main MATs, why they’re used and the challenges these treatments can present to health care providers.

What Are Opioids?

Before we dive into how and why MATs are used, let’s ground ourselves by defining what opioids are and why they’re so addictive.

To begin, typical opioid prescriptions include fentanyl, codeine, morphine, oxymorphone, hydrocodone and oxycodone. These drugs are commonly used across the U.S. for conditions like chronic pain, cancer treatment and recovery after surgery. Heroin, considered one of the most dangerous opioids, is never used medically in the U.S.

Methadone and buprenorphine, both frequently used in MAT programs, have a similar chemical function to opioids, as they stimulate similar brain receptors. Although it may seem counterintuitive to use these substances for treatment, they help prevent withdrawal symptoms and cravings due to their slow action and the lack of euphoria they produce compared to other opioids like heroin.

The “Why” Behind MAT

MAT helps individuals living with OUD find relief from withdrawal symptoms, opioid cravings and potential overdose through medicine-based interventions. The four types of medications approved for MAT programs are methadone, buprenorphine, naltrexone and naloxone.

Let’s quickly review each of these.

Methadone

Methadone, the most renowned MAT medication, has been used to treat OUDs, especially heroin, for decades. Typically administered in clinics under supervised conditions, methadone can be addictive and must be taken as prescribed to avoid misuse or overdose.

Buprenorphine

Approved by the Food and Drug Administration in 2002, buprenorphine’s usage by qualified physicians in various settings has notably broadened access to treatment. It has a “ceiling effect” that limits abuse or dependence risks.

Naltrexone

Unlike methadone and buprenorphine, naltrexone does not trigger opioid receptors in the brain. Instead, it reduces cravings by blocking euphoria or sedation. Naltrexone is not addictive, but requires patients to be opioid-free for at least seven days if they last used short-acting opioids or 10-14 days if they last used long-acting opioids.

Naloxone

Commonly known as Narcan, naloxone is used during opioid overdose emergencies. Prescribed by health care providers and often carried by first responders, naloxone can reverse an opioid overdose, but only if opioids are present in the system.

How MAT Relates to Whole-person Care

Whole-person care is based on the understanding that the body is an interconnected system. It recognizes that just as organs do not function in isolation, mental and physical health are closely related. For MAT interventions to prove effective, they must operate within this paradigm.

Indeed, the health care community agrees that combining medication with counseling and community support groups, as advocated by the Substance Abuse and Mental Health Services Administration (SAMHSA), forms the gold standard in treatment. Federal law mandates MAT patients must receive additional medical, counseling and social support services, including education and vocational support, ensuring a comprehensive approach toward their recovery.

Integrating care in the same clinic via a collaborative treatment team — physicians, therapists, social workers, nurses and peer support specialists — is increasingly common.

The Good and the Bad of the Current MAT Landscape

Research indicates that MAT programs significantly improve long-term recovery rates, health outcomes, and quality of life for OUD patients, with a notable reduction in risk of recurrence. Advocacy groups, mental health organizations and governmental bodies have promoted increased access and funding for MAT, resulting in broader service availability across the U.S.

Despite these promising results, a significant disparity exists in the U.S. between those clinically eligible for OUD treatment and those who receive it. Several social barriers have led to this gap, such as:

• There’s significant stigma around substance use disorders (SUDs).
• Restrictions on MAT administration can limit new patient intake.
• Not all centers offer a full range of MAT medications, restricting options.
• Lack of coordination with mental health professionals hinders MAT administration (particularly in rural areas).

The Need for Competent Care

Given the intricate nature of OUD, affected individuals are among the most vulnerable and require knowledgeable, compassionate health care providers and communities. These professionals should be adequately trained to support individuals throughout the treatment process and connect them to essential resources for positive outcomes. To help your staff get to a space where they can provide this high level of care, offer training that helps them better understand, prevent, and treat opioid use and misuse within the context of whole person health.

For Relias’ 2024 Behavioral Health Crisis Management Training Report, we asked respondents what would increase their confidence in treating SUDs. The most popular answers were more continuing education opportunities (55%), more practice of related skills (50%) and a wider variety of training options (43%). To provide the type of training that would increase your staff’s confidence in treating SUDs, and thus their ability to provide competent care, consider investing in a learning platform. With learning platforms such as Relias, you can offer an array of training formats that give your staff the ability to learn and practice the skills they need to make the biggest difference in your community.