Description of Strategy
Medication-assisted treatment (MAT) is the use of medication alongside counseling and behavioral therapy to treat opioid use disorder. MAT is any treatment for opioid addiction that includes a medication (e.g., methadone, buprenorphine, and naltrexone) approved by the U.S. Food and Drug Administration (FDA) for opioid addiction detoxification or maintenance treatment. MAT may be provided through a physician’s office, substance abuse treatment facility, or other health care setting.
As of 8/21/20, Wyoming has 98 publicly-listed buprenorphine prescribers in the state. Some of these practitioners provide telehealth services. In addition, there are currently 15 MAT providers listed on the Wyoming Department of Health website. These sites provide comprehensive services, such as group and individual therapy, in addition to medication management.
Another drug commonly used in MAT, methadone, is required to be dispensed through a SAMHSA-certified opioid treatment program (OTP). There are zero OTPs in Wyoming.
Discussion of Effectiveness
Medication-assisted treatment should be considered an effective method for addressing opioid use disorder, especially when combined with counseling. There are a broad number of counseling options that when combined with MAT will significantly reduce the likelihood that a patient will relapse or overdose (Fudela, 2003; Comer et al., 2006; Mattick et al., 2009). In fact, MAT when combined with counseling is more effective than medication or counseling alone (Schuckit, 2016).
Busch, S. H., Fiellin, D. A., Chawarski, M. C., Owens, P. H., Pantalon, M. V., Hawk, K., Bernstein, S. L., O’Connor, P. G., & D’Onofrio, G. (2017). Cost-effectiveness of emergency department-initiated treatment for opioid dependence. Addiction, 112(11), 2002–2010.
Comer, S. D., Sullivan, M. A., Yu, E., Rothenberg, J. L., Kleber, H. D., Kampman, K., Dackis, C., & O’Brien, C. P. (2006). Injectable, sustained-release naltrexone for the treatment of opioid dependence: A randomized, placebo-controlled trial. Archives of General Psychiatry, 63(2), 210–218.
Fudela, P. J., Bridge, P., Herbert, S., Williford, W. O., Chiang, C. N., Jones, K., Collins, J., Raisch, D., Casadonte, P., Goldsmith, R. J, Ling, W., Malkerneker, U., McNicholas, L., Renner, J., Stine, S., Tusel, D., & Buprenorphine/Naloxone Collaborative Study Group. (2003). Office-based treatment of opiate addiction with a sublingual-tablet formulation of buprenorphine and naloxone. New England Journal of Medicine, 349(10), 949–58.
Mattick, R. P., Breen, C., Kimber, J., & Davoli, M. (2009). Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence. Cochrane Database of Systematic Reviews, 8(3), 1–27.
Menchine, M. D., Axeen, S., Plantmason, L., & Seabury, S. (2014). Strength and dose of opioids prescribed from US emergency departments compared to office practices: Implications for emergency department safe-prescribing guidelines. Annals of Emergency Medicine, 64(4), S1.
The Pew Charitable Trusts. (2016). Medication-assisted treatment improves outcomes for patients with opioid use disorder: Combination of behavioral health interventions and FDA-approved drugs can help reduce illicit opioid use.
Schuckit, M. A. (2016). Treatment of opioid-use disorders. New England Journal of Medicine, 375(4), 357–68.