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M.A.T. Medically Assisted Therapy Jeanne Kapenga, M.D. Medically - PowerPoint PPT Presentation

Aug 06, 2023 •292 likes •470 views

M.A.T. Medically Assisted Therapy Jeanne Kapenga, M.D. Medically Assisted Therapy Recognized to aid in successful recovery programs along with counseling for 90% of patients Allows the natural neurochemistry to return to opioid/drug

  1. M.A.T. Medically Assisted Therapy Jeanne Kapenga, M.D.

  2. Medically Assisted Therapy  Recognized to aid in successful recovery programs along with counseling for 90% of patients  Allows the natural neurochemistry to return to opioid/drug damaged brains by preventing cravings (and withdrawal)  This process may take a year  Some may never fully recover

  3. Allows focus on counseling  Cravings are distracting, and MAT provides medically proven improvement so pt’s can focus on their lifestyle changes  The longer the period of abstinence, the sooner the brain’s neurochemistry normalizes and decision-making improves

  4. THREE MAJOR GROUPS  METHADONE: Gold standard - Opioid addiction  BUPRENORPHINE: Suboxone, Subutex, etc - Opioid addiction  NALTREXONE: Revia, Vivitrol (injection) - Opioid or alcohol addiction

  5. METHADONE  Federally regulated; distributed daily at a clinic  Euphoria effect; legal heroin  Long half-life means a long taper period  Inexpensive

  6. BUPRENORPHINE  Several formulations: with or without naloxone (added for safety)  Taken once or twice daily at home  Federally regulated; X-waiver  Diversion

  7. NALTREXONE  Not a controlled substance so not federally regulated  No real diversion factor (no euphoria)  Blocks cravings only  For opioid or alcohol addiction

  8. MAT does not work alone  Is an adjunct to counseling, group therapy, step/community based groups and recovery coaching  Benefits seen over time ie months to a year as the brain neurochemistry heals

  9. MAT and the Family  Allows them to remain at home, employed and functioning as a member of the family unit, if engaged in recovery  Encourage family members to learn about the disease of addiction as the pt enters recovery, for best treatment outcome

  10. COMMUNITY COLLABORATION  This crisis is the “Worst man -made epidemic known to mankind” per CDC  Scope and continuing escalation has been underestimated  First time Judicial/Law Enforcement have made medical decisions for sentencing

  11. SCOPE OF THE EPIDEMIC  Prevention: Education in schools Disrupting the supply Surgery, dental, athletic entry  Treatment: Engaging when ready Engaging when not ready  “Meet them where THEY are at”

  12. IT WILL TAKE A VILLAGE  Schools  Law enforcement  Judicial system  Medical providers  Hospital/health care delivery systems  Community based agencies  Governmental at all levels

  13. HEALTHCARE/HOSPITAL SYSTEM  Multiple sectors of care involved  Emergency room: Point of contact for overdose or other medical need - Assess for readiness for treatment  Long term treatment options (months)

  14. LAW ENFORCEMENT  Now practicing medicine in the field with naloxone administration and transport to the E.D. if possible  Even if they remain at home, option for tx

  15. JUDICIAL SYSTEM  Incarceration is NOT the solution, but treatment while incarcerated is  Again, Judges are practicing medicine  National trend for mandating treatment

  16. STATISTICS  Important in organizing our data collection here in MI: underreporting  Evidence based decisions will depend upon accurate, timely statistics (daily) to recognize mass overdose situations  Identifying demographic factors for determining policy in prevention  Identifying locations of high use/resources

  17. STATISTICS (continued)  Evaluating resource efficacy – are the resources placed where they are needed? Are they effective?  Standardized Medical Examiner reporting  Developing evidence-based treatment programs in the community  Don’t have time now to do formal 5 year studies – sense of urgency

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