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MEDICATION-ASSISTED TREATMENT FOR SUBSTANCE USE DISORDERS, INCLUDING ALCOHOL AND TOBACCO DEPENDENCE

Wellpath Community Care Centers provide effective evidence-based MAT programs for Opioid Dependence, Alcohol Dependence, and Tobacco Dependence.

What is Medicated Assisted Treatment (MAT)? Medicated Assisted Treatment is the use of FDA-approved medications, in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to the treatment of substance use disorders.

COMBINING MEDICATION, COUNSELING AND LIFESTYLE

According to the Substance Abuse and Mental Health Service Administration (SAMHSA) and the National Institute on Drug Abuse, addiction is a chronic, treatable disease. This means that successfully treating addiction is similar to treating chronic conditions like diabetes and cardiovascular disease. This is 100% correct and exactly what Wellpath Community Care Center programs are all about. We’re simply combining medication, counseling and lifestyle modification to create positive patient outcomes.

We combine medication with counseling to create behavioral/lifestyle modifications that support patient success like abstinence, employment, and successful relationships. It’s important to note that similar to chronic disease treatment, some Wellpath patients may find in time, because of behavioral changes the medication can be reduced or stopped. However, many patients, like other chronic conditions, may need to remain on medication indefinitely to help them achieve and maintain meaningful, successful lives.

A. MEDICATIONS

For Opioid Use Disorder – Methadone, buprenorphine, and naltrexone are used to treat opioid dependence and addiction to short-acting opioids such as heroin, morphine, and codeine, as well as semi-synthetic opioids like oxycodone and hydrocodone. People may safely take medications used in MAT for months, years, several years, or even a lifetime. Plans to stop a medication must always be discussed with a doctor.

  1. Buprenorphine/Naloxone – Like methadone, buprenorphine suppresses and reduces cravings for the abused drug. It can come in a pill form or sublingual tablet that is placed under the tongue.
  2. Naltrexone/Vivitrol – Naltrexone works differently than methadone and buprenorphine in the treatment of opioid use disorder. If a person using naltrexone relapses and uses the abused drug, naltrexone blocks the euphoric and sedative effects of the abused drug and prevents feelings of euphoria.

For Alcohol Use Disorder – Disulfiram, acamprosate, and naltrexone are the most common drugs used to treat alcohol use disorder. None of these drugs provide a cure for the disorder, but they are most effective in people who participate in substance use disorder counseling.

  1. Disulfiram – Disulfiram is a medication that treats chronic alcoholism. It is most effective in people who have already gone through detoxification or are in the initial stage of abstinence. This drug is offered in a tablet form and is taken once a day.
  2. Naltrexone – When used as a treatment for alcohol use disorder, naltrexone blocks the euphoric effects and feelings of intoxication. This allows people with alcohol addiction to reduce their drinking behaviors enough to remain motivated to stay in treatment, avoid relapses, and take medications.

For Tobacco Use Disorder – Tobacco dependence has proved to be a chronic disease that often requires repeated intervention and multiple attempts to quit. Wellpath Community Care Center programs acknowledge the importance of identifying tobacco use and encourage counselors to introduce every patient willing to quit to the recommended counseling treatments and medications. Bupropion, Nicotine replacement therapy and Varenicline are the most common drugs used to treat alcohol use disorder. None of these drugs provide a cure for the disorder, but they are most effective in people who participate in Wellpath Community Care MAT programs.

  1. Bupropion – Bupropion (brands: Wellbutrin, Zyban, Aplenzin, Buproban, Budeprion, Forfivo) is an antidepressant medication that can be helpful for treating tobacco use disorder by reducing cravings and helping with nicotine withdrawal symptoms. It has multiple sustained- and extended-release formulations, which have varying dose ranges.
  2. Varenicline – Varenicline (brands: Chantix) is a prescription medication used to treat tobacco use disorders. Varenicline attaches to nicotine receptors in the brain so that nicotine can’t attach to these receptors. Thus, less dopamine is released to help people quit smoking.
  3. Nicotine Replacement Therapy – Nicotine replacement therapy reduces nicotine withdrawal and cravings and can therefore help people stop using nicotine-containing products. However, it can also be useful to help people cut down on their use of nicotine-products or not use these products in places where they are not allowed to (e.g. addiction treatment settings, restaurants jobs), even if they are not ready or willing to stop using entirely. It comes in five different formulations, all of which have widely varying dose ranges.

B. COUNSELING SERVICES

Evidence-based counseling practices are utilized in Wellpath Community Care Centers. A key component of our Wellpath Community Care programs are our evidence-based counseling services. Provided by a team of seasoned addiction specialists, every patient receives a customized counseling plan carefully crafted from a range of the following therapies and modalities.

  1. Motivational Interviewing (MI): Motivation has been acknowledged to be a key to substance use behavior change. Motivational Interviewing (MI) is an evidence-based therapy style that focuses on helping patient resolve ambivalence about and enhance motivation to change health-risk behaviors, including illicit substance use.
  2. Motivational Enhancement Therapy (MET): Motivational Enhancement Therapy (MET) is a brief motivational counseling approach that provides personalized, neutral, motivational interviewing-style feedback to patients. Through this evidence-based therapy style, counselors elicit patients’ understanding of feedback, followed by reflections and listening for signs that patients are considering behavioral changes based on the feedback.
  3. Cognitive Behavioral Therapy (CBT): Cognitive Behavioral Therapy (CBT) is a general classification of psychotherapy, based on social learning theory, which emphasizes how our thinking interacts with how we feel and what we do. This evidence-based therapy style is based on the view that when a person experiences depression, anxiety or anger that these stressors can be exacerbated (or maintained) by exaggerated or biased ways of thinking and that these patterns can be modified by reducing erroneous and maladaptive beliefs. Through this therapy style, counselors can help patients recognize their style of thinking and to modify it through the use of evidence and logic.
  4. Solution-Focused Therapy: Solution-focused therapy is based on the belief that by helping patients with substance abuse disorders to address any life problems they find significant will help them to reduce their substance use. Important to solution-focused therapy is finding a solution to the problems the patient identifies as significant, then reinforcing the patient’s success in solving those problems. This procedure helps the patient to recognize their own ability to solve problems.
  5. Stages of Change Work: The Stages of Change is a Transtheoretical Model which focuses on the decision-making of the individual. The model is meant to be utilized for intentional change. The basis of Stages of Change is that persons do not change behaviors quickly nor decisively, but rather, persons make behavioral changes through a continuous process. Wellpath Community Care program clinicians understand the five stages of change: precontemplation, contemplation, preparation, action, maintenance and recovery. The treatment model allows for clinicians to “meet patients where they are in their recovery” and helps clinicians better understand a patient’s motivation for recovery.