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Medication Assisted Treatment

Milestone Addiction Counseling now offers medication assisted treatment services. Milestone Addiction Counseling focuses on the importance of addressing all facets of an individual’s addiction, which often includes use of medication assisted treatment to support counseling services. Please contact Milestone at (614) 710-1496 or (614) 943-1105 to schedule an intake appointment with the agency.



What Is Medication Assisted Treatment?

Buprenorphine is the first medication to treat opioid dependency that can be prescribed in physicians’ offices, which has helped to significantly increases treatment access for those in need. Buprenorphine was approved by the FDA for clinical use in 2002. It is classified as a partial opioid agonist. This means that it produces mild euphoria and respiratory depression. But the effects of buprenorphine are substantially weaker that those caused by heroin. Its effects level off at moderate doses – also known as a “ceiling effect” – which in turn lowers the risk of misuse and dependency.

Naltrexone (Vivitrol), the other commonly used medication assisted therapy, should also be used in conjunction with behavioral counseling. Naltrexone is an opioid antagonist that blocks the euphoric and sedative effects of opioids such as heroin. If the patient relapses and uses an opioid, naltrexone prevents the feeling of getting “high”. A recent study also concluded that naltrexone also effectively reduces cravings. SAMHSA states: “As with all medications used in MAT, naltrexone is to be prescribed as part of a comprehensive treatment plan that includes counseling and participation in social support programs.”

The State of Ohio has recognized the importance of linking buprenorphine treatment to behavioral counseling. In fact, the Ohio Administrative Code demands it. Ohio Administrative Code 4731-11-12 states: “The physician shall require each [buprenorphine] patient to actively participate in appropriate behavioral counseling or treatment for their addiction and shall document at each visit that the patient is attending sufficient behavioral health treatment".

Milestone Addiction Counseling provides medication assisted treatment, along with counseling services geared toward the needs of those participating in medication assisted treatment with buprenorphine/naloxone (Suboxone) as well as naltrexone (Vivitrol). Our mission is to serve individuals suffering from addiction by providing high quality chemical dependency counseling services with a focus on those receiving medication-assisted treatment. We are committed to serving your patients and our clients with respect, compassion, and professionalism.

About MAT

Federal law requires patients who receive treatment in an OTP to receive medical, counseling, vocational, educational, and other assessment and treatment services, in addition to prescribed medication. The law allows MAT professionals to provide treatment and services in a range of settings, including hospitals, correctional facilities, offices, and remote clinics. Learn more about the legislation, regulations, and guidelines that govern OTPs.

MAT Effectiveness

In 2013, an estimated 1.8 million people had an opioid use disorder related to prescription pain relievers, and about 517,000 had an opioid use disorder related to heroin use. MAT has proved to be clinically effective and to significantly reduce the need for inpatient detoxification services for these individuals. MAT provides a more comprehensive, individually tailored program of medication and behavioral therapy. MAT also includes support services that address the needs of most patients. The ultimate goal of MAT is full recovery, including the ability to live a self-directed life. This treatment approach has been shown to:

  • Improve patient survival
  • Increase retention in treatment
  • Decrease illicit opiate use and other criminal activity among people with substance use disorders
  • Increase patients’ ability to gain and maintain employment
  • Improve birth outcomes among women who have substance use disorders and are pregnant

Research also shows that these medications and therapies can contribute to lowering a person’s risk of contracting HIV or hepatitis C by reducing the potential for relapse. Learn more about substance misuse and how it relates to HIV, AIDS, and Viral Hepatitis. Learn more about common comorbidities that occur with substance use disorders.


Unfortunately, MAT is greatly underused. For instance, according to SAMHSA’s Treatment Episode Data Set (TEDS) 2002-2010, the proportion of heroin admissions with treatment plans that included receiving medication-assisted opioid therapy fell from 35% in 2002 to 28% in 2010. The slow adoption of these evidence-based treatment options for alcohol and opioid dependence is partly due to misconceptions about substituting one drug for another. Discrimination against MAT patients is also a factor, despite state and federal laws clearly prohibiting it. Other factors include lack of training for physicians and negative opinions toward MAT in communities and among health care professionals.

MAT and Patient Rights

SAMHSA’s Partners for Recovery Initiative produced a brochure designed to assist MAT patients and to educate and inform others. Under the Confidentiality Regulation, 42 Code of Federal Regulations (CFR) 2, personally identifiable health information relating to substance use and alcohol treatment must be handled with a higher degree of confidentiality than other medical information.


Medications Used in MAT

FDA has approved several different medications to treat opioid addiction and alcohol dependence. A common misconception associated with MAT is that it substitutes one drug for another. Instead, these medications relieve the withdrawal symptoms and psychological cravings that cause chemical imbalances in the body. MAT programs provide a safe and controlled level of medication to overcome the use of an abused opioid. And research has shown that when provided at the proper dose, medications used in MAT have no adverse effects on a person’s intelligence, mental capability, physical functioning, or employability. Medications used in MAT for opioid treatment can only be dispensed through a SAMHSA-certified OTP. Some of the medications used in MAT are controlled substances due to their potential for misuse. Drugs, substances, and certain chemicals used to make drugs are classified by the Drug Enforcement Administration (DEA) into five distinct categories, or schedules, depending upon a drug’s acceptable medical use and potential for misuse. Learn more about DEA drug schedules.



Medications Used in MAT

FDA has approved several different medications to treat opioid addiction and alcohol dependence.

A common misconception associated with MAT is that it substitutes one drug for another. Instead, these medications relieve the withdrawal symptoms and psychological cravings that cause chemical imbalances in the body. MAT programs provide a safe and controlled level of medication to overcome the use of an abused opioid. And research has shown that when provided at the proper dose, medications used in MAT have no adverse effects on a person’s intelligence, mental capability, physical functioning, or employability.

Medications used in MAT for opioid treatment can only be dispensed through a SAMHSA-certified OTP. Some of the medications used in MAT are controlled substances due to their potential for misuse. Drugs, substances, and certain chemicals used to make drugs are classified by the Drug Enforcement Administration (DEA) into five distinct categories, or schedules, depending upon a drug’s acceptable medical use and potential for misuse. Learn more about DEA drug schedules.

Opioid Dependency Medications

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.

Methadone

Methadone tricks the brain into thinking it’s still getting the abused drug. In fact, the person is not getting high from it and feels normal, so withdrawal doesn’t occur. Learn more about methadone.

Pregnant or breastfeeding women must inform their treatment provider before taking methadone. It is the only drug used in MAT approved for women who are pregnant or breastfeeding. Learn more about pregnant or breastfeeding women and methadone.

Buprenorphine

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. Learn more about buprenorphine.

Naltrexone

Naltrexone works differently than methadone and buprenorphine in the treatment of opioid dependency. 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. Learn more about naltrexone.

Opioid Overdose Prevention Medication

FDA approved naloxone, an injectable drug used to prevent an opioid overdose. According to the World Health Organization (WHO), naloxone is one of a number of medications considered essential to a functioning health care system.

Alcohol Use Disorder Medications

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 a MAT program. Learn more about the impact of alcohol misuse.

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. Disulfiram should never be taken while intoxicated and it should not be taken for at least 12 hours after drinking alcohol. Unpleasant side effects (nausea, headache, vomiting, chest pains, difficulty breathing) can occur as soon as ten minutes after drinking even a small amount of alcohol and can last for an hour or more.

Acamprosate

Acamprosate is a medication for people in recovery who have already stopped drinking alcohol and want to avoid drinking. It works to prevent people from drinking alcohol, but it does not prevent withdrawal symptoms after people drink alcohol. It has not been shown to work in people who continue drinking alcohol, consume illicit drugs, and/or engage in prescription drug misuse and abuse. The use of acamprosate typically begins on the fifth day of abstinence, reaching full effectiveness in five to eight days. It is offered in tablet form and taken three times a day, preferably at the same time every day. The medication’s side effects may include diarrhea, upset stomach, appetite loss, anxiety, dizziness, and difficulty sleeping.

Naltrexone

When used as a treatment for alcohol dependency, 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. Learn more about how naltrexone is used to treat alcohol dependency.

Access Medication for the Treatment of Alcohol Use Disorder: A Brief Guide – 2015 to learn more about MAT for alcohol use disorder.



MAT Medications and Child Safety

It’s important to remember that if medications are allowed to be kept at home, they must be locked in a safe place away from children. Methadone in its liquid form is colored and is sometimes mistaken for a soft drink. Children who take medications used in MAT may overdose and die.



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Additional Resources

Access information about SAMHSA’s federal partners, associations, and other support organizations that offer MAT-related resources for consumers and substance use treatment professionals.