Statistics from the National Institute on Drug Abuse (NIDA) report that 25 million Americans have an addiction to alcohol, tobacco, and illicit drugs. The cost for associated crime, lost productivity, and providing treatment in this country alone is over $700 billion annually. The opioid epidemic accounts for $55 billion each year. There are 2 million Americans meeting criteria for an opioid use disorders because of prescription opioid use and an additional 0.5 million meeting criteria because of their heroin use. The death rate for opioid overdose deaths is now comparable with that of motor vehicle crashes.
Opioid use disorder or "addiction involving opioid use" is a fundamental neurological disease that affects brain reward, motivation, memory, and the related circuitry. The impact of the various psychoactive substances and their action on specific neurotransmitter systems and their receptors has been identified. Research has been conducted on ways that this impact can be mediated. Certain pharmacologic agents appear to be effective as clinical interventions. Recommendations for evidence-based treatment for opioid use disorders support the use of medication in conjunction with counseling and behavioral interventions. Stigma is a barrier against medication-assisted treatment (MAT). The following resources provide important information for understanding the role of medications in treatment.
http://www.samhsa.gov/medication-assisted-treatment
The Programs and Campaigns section of the Substance Abuse Mental Health Services Administration (SAMHSA) has a very complete page offering broad coverage of SAMHSA and related resources. The main page is updated as of August 2014, and all the content can be considered current. The site has authority and accuracy. There are links to information on opioid programs, legislation, and regulations; resources for the patients, families, and providers; and information on the medications and how they interact with comorbidities. This information is organized by blocks and can be easily accessed and easily shared through email and RSS feeds. There are no hidden costs or advertising. No special software is required. Contact information is visible as are links to a variety of social media sites, related government sites, and the Division of Pharmacologic Therapies.
http://dpt.samhsa.gov/
http://www.dpt.samhsa.gov/pdf/FederalGuidelines2015_508.pdf
Substance Abuse and Mental Health Services Administration. (2015). Federal Guidelines for Opioid Treatment Programs [HHS Publication No. (SMA) PEP15-FEDGUIDEOTP]. Rockville, MD: Author.
The Division for Pharmacologic Therapies (DPT) is responsible for the day-to-day regulatory oversight activities associated with the implementation of SAMHSA regulations 42 CFR Part 8 and the Drug Addiction Treatment Act of 2000 (DATA 2000). DPT supervises the certification and accreditation of the over 1250 opioid treatment programs (methadone clinics) that treat over 300,000 patients annually with the opioid agonist medications approved by the Food and Drug Administration (methadone, LAAM, and buprenorphine) and the medication-assisted opioid addiction treatment provided in settings outside traditional treatment programs. In addition to providing the same links as the SAMHSA MAT Web site, DPT provides access to the full 2015 Federal Guidelines for Opioid Treatment Programs through electronic download from a highlighted area on the home page. Special software is required for download, but a link is included to obtain the software for free. All information is current, accurate, and objective. The page can be searched by scrolling, by use of a search engine, or through the index on the left side. Contact information is extensive with telephone numbers and addresses for email, mail, and overnight. In addition, information is given for all staff and their role at DPT.
http://www.drugabuse.gov/publications/research-reports/prescription-drugs/direct
http://www.drugabuse.gov/publications/research-reports/prescription-drugs/treati
The NIDA Web site has a section dedicated to prescription drug abuse where NIDA Director Nora Volkow addresses the gravity of this issue; the specific medications that are abused; and which medications are used to treat prescription opioids, pain, and addiction and offers links to additional information. This site is current with an update of November 2014. It speaks with the authority and accuracy of the director and the institute and has contact information for a variety of users; for obtaining information; how to cite the information on the pages; and telephone, email, and postal mail contact information including directions to the office. There are no advertisements or costs associated with getting the information. Many links are included to increase accessibility through free software, a PDF version that downloads a 16-page National Institutes of Health Research Report, a Spanish version of the Web site, and ePub and Kindle versions of the content. There is also a print button to allow ease of printing the material directly from the page. This page is appropriate for patients, families, and professionals.
https://store.samhsa.gov/shin/content/SMA09-4443/SMA09-4443.pdf
http://www.kap.samhsa.gov
Knowledge Application Program. (2011). Medication-Assisted Treatment for Opioid Addiction: Facts for Families and Friends [brochure]. SAMHSA, U.S. Department of Health and Human Services (HHS).
The Knowledge Application Program at SAMHSA was developed to support professional development within the behavioral health system by providing information and resources for best practice. One of these resources is the educational brochure for families. Just 20 pages long and written in an easy-to-read casual style, this document contains a complete education on the disease of opioid addiction, the approaches for treating it, medications that are used, worksheets with goals, and lists of support groups, additional educational materials, and treatment locators. The KAP site has authority, accuracy, and objectivity. The contact information is the same as that on the MAT SAMHSA site. Materials are current and easy to download with free software, but it is very difficult to search the site for the materials you want. It is much easier to go directly to the SAMHSA store site for this brochure. Because this is in the public domain, you can distribute it to patients, clients, families, and friends for free; just be sure to acknowledge and cite the source.
http://www.ncbi.nlm.nih.gov/books/NBK64157/
Center for Substance Abuse Treatment. (2005). Medication-assisted treatment for opioid addiction in opioid treatment programs. Rockville, MD: Substance Abuse and Mental Health Services Administration (US). Retrieved fromhttp://www.ncbi.nlm.nih.gov/books/NBK64157/
The Treatment Improvement Protocol Series (TIP) is one of the publications of the Knowledge Application Program. The National Center for Biotechnology Information contains an easy-to-access database for all current and archived TIPs with a link for downloading an electronic copy. This link refers to Chapter 2 of TIP 43 Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs, but the entire TIP is available at this site. It is interesting to note that, during and after the Civil War, opioids were used for acute and chronic pain leading to opioid addiction first emerging as a serious problem in this country. The numbers dwindled with the aging of this population, but there were still 300,000 persons addicted to opioids in 1900. This history covers significant events, significant regulatory changes, the search for a way to address the problem, and the origin of opioid maintenance therapy. This is the best place to find the complete history.
https://www.whitehouse.gov/ondcp
https://www.whitehouse.gov/sites/default/files/ondcp/recovery/medication_assiste
Office of National Drug Control Policy, Executive Office of the President. (2012). Healthcare brief. Medication assisted treatment for opioid addiction. Retrieved fromhttp://www.Whitehouse.gov/ONDCP
The Office of National Drug Control Policy (ONDCP) was created in 1988 through the passage of the Anti-Drug Abuse Act as a component of the Executive Office. It states it mission as "seeks to foster healthy individuals and safe communities by effectively leading the Nation's effort to reduce drug use and its consequences." ONDCP develops the annual National Drug Control Strategy and carries it out. The Web site is rich in current information, including drug use statistics by state; it speaks with the accuracy, authority, and objectivity of the highest office. There are no advertisements or any costs associated with accessing the information. Contact information is available through a Stay Connected page and links to Email Updates, Twitter (English and Spanish), Facebook, the ONDCP blog, RSS feeds, YouTube, and the newsletter ONDCP Update. It is easy to sign up for your favorite way to stay connected and receive links to the most current information, decisions, and publications. One example of the type of material that is available is this September 2012 Health Brief on Medication-Assisted Treatment for Opioid Addiction that supports the use of medication and psychosocial therapy.
http://nasadad.org/wp-content/uploads/2011/06/NASADAD-Statement-on-MAT.pdf
National Association of State Alcohol and Drug Abuse Directors, Inc.
Consensus Statement on the Use of Medications in Treatment of Substance Use Disorders
Around the same time that ONDCP developed their health brief, the National Association of State Alcohol and Drug Abuse Directors, Inc., developed their Consensus Statement on the Use of Medications in Treatment of Substance Use Disorders. This is a one-page document that offers "talking points" that support the use of medication. Authorities such as the National Quality Forum and the American Society for Addiction Medicine (ASAM) are used to support their recommendation.
A number of other organizations have developed supportive documents and policy statements.
http://www.aatod.org/
http://www.aatod.org/policies/policy-statements/increasing-access-to-medication-
American Association for Treatment of Opioid Dependence. (2014 2). Increasing access to medication to treat opioid addiction-Increasing access for the treatment of opioid addiction with medications. Retrieved fromhttp://www.aatod.org/wp-content/uploads/2014/07/MAT-Policy-Paper-FINAL-070214-2.
Since its founding in 1984, the American Association for the Treatment of Opioid Dependence has worked toward quality patient care in the treatment of opioid use disorders by promoting the growth and development of comprehensive opioid treatment services throughout the United States. The Web site promotes this goal with advertising and requests for donations but provides the educational and resource information free of charge. There are a President's Corner, a blog, and links to a large variety of social media (Twitter, Google+, Facebook, LinkedIn, and more). All policy statements are accessible under the policies link on the Web site. The example given here is a recent policy paper encouraging increased access to the use of medications in treating opioid addiction. Accuracy, authority, and objectivity are based on the history and reputation of the organization. Contact information is clearly visible, and the content of the site is available for patients, families, and professionals.
http://www.asam.org/
http://www.asam.org/docs/default-source/publicy-policy-statements/pharmacologica
http://www.asam.org/docs/default-source/advocacy/aaam_implications-for-opioid-ad
http://www.asam.org/docs/default-source/practice-support/guidelines-and-consensu
The ASAM mission is to increase access to addiction treatment and improve the quality of treatment by providing education, supporting research and prevention, and promoting the recognition of addiction medicine as a specialty. The Web site is current to 2015 and provides links to a career center for employers and job seekers; a store for ASAM items, books, and other publications; a support catalogue for resources; membership information; practice support such as guidelines, policy statements, and consensus documents; and an index of links for research and treatment information. ASAM is an authority and speaks with accuracy and objectivity. There are some costs involved through the purchase of items and publications through the online store, but practice resources are available in electronic format for free. The included hyperlinks are for a public policy statement supporting the use of pharmacologic therapies, an advocacy study titled the Medicaid Medication-Assisted Treatment Survey and Study Report, and the May 2015 National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use. There is full contact information on the Web site and links for frequently used social media. This is a good site to use for accessing resources for practice.
http://www.drugfree.org
http://www.drugfree.org/wp-content/uploads/2014/05/MAT_EBOOK_2014v2.pdf
Drugfree.org is the Web site of the Partnership for Drug-Free Kids. It was established in 1987 as an antidrug advertising campaign, the Partnership for a Drug-Free America. In its new format, it works to support families and engage teens with the goal to reduce teen substance abuse. The site focuses on making it easy to get information, to get help, and to get involved. The organization gets its authority and accuracy from the experts it cites on the page. There are a number of state alliances identified. Requests for financial support for the work are at the top and bottom of the page. Contact information is clear, and it is possible to click a link at the top of the page for a Spanish version of the Web site. Links are included down the left side for all social media, sharing the information through email, and printing your own copy. The site is clearly organized to capture interest, share statistics, and educate the public about the threat of substance abuse. There are some good e-books, guides, and resources that are free and can be downloaded and printed. One example is Medication-Assisted Treatment: An eBook for Parents & Caregivers of Teens & Young Adults Addicted to Opioids. This e-book is similar in content to the SAMHSA publication Medication-Assisted Treatment for Opioid Addiction: Facts for Families and Friends. However, the Partnership is much larger and more thorough. The Web site and its content are appropriate for professionals, families, and the general public.
http://pcss-o.org/
http://pcssmat.org/
The Providers' Clinical Support System for Opioid Therapies and for Medication-Assisted Treatments are part of a national training and mentoring project that was developed in response to the prescription opioid overdose epidemic. Evidence-based educational resources are provided through live and archived Webinars, and a system of support and mentoring is available to increase providers' confidence in using MAT. Continuing education units can be obtained for attending the live Webinars.
http://www.naadac.org/medication-assisted-treatment-november
NAADAC, the Association for Addiction Professionals, has developed a free Webinar "The Ins & Outs of Medication-Assisted Treatment & Recovery for Opioid Dependence" hoping to bring together addiction and other professionals from differing disciplines to learn about medication-assisted therapies. It is hoped that providing information on new advancements in evidence-based treatment will challenge long held ideas and perceptions so professionals from all backgrounds will begin to think about treatment and recovery in new ways
http://www.socialworktoday.com/archive/091514p30.shtml
Reardon, C. (2014). Medication-assisted treatment: A tool to support addiction recovery. Social Work Today, 14(5), 3.
Last fall, Social Work Today decided to look at the evidence supporting MAT in this article from one of their contributing editors. The author identified that the growing concern over opioid abuse along with the push for greater integration of primary care and behavioral health services has lead to a trend toward greater use and acceptance of MAT. She observed that social workers have the potential to play a leading role in making sure MAT is used effectively and ethically. In her article, she discusses the medications that are used, factors that have held back use, and what it will take for MAT to gain acceptance and shares approaches for integrating MAT and psychosocial therapy. This is a very thought provoking article for any discipline to read.
Whether you already work with MAT, support the use of MAT, or are still in the need to be convinced, these Web sites and resources have something for you. Do a little indoor surfing while you wait for the weather to warm back up.