What is Medication Assisted Treatment (MAT)?
Transitions Clinic Network (TCN) hosts a monthly Frequently Asked Questions (FAQ) column. We answer questions about health care and empower individuals to prepare for healthy reentry. This month we are writing about Medication Assisted Treatment (MAT) for substance use disorders.
What is MAT?
MAT is the use of medications approved by the U.S. Food and Drug Administration (FDA) and prescribed by a medical provider for the treatment of substance use disorders (SUD). For people struggling with addiction, these medications can help reduce cravings and substance use, and prevent overdose. While many can do well using only medications to treat SUD, research shows that many may need counseling and behavioral health services to achieve full, sustained recovery. Any treatment plan or services should be responsive to the goals, priorities, and preferences of the individual.
What conditions can I take MAT for?
Not everyone who uses substances has a disorder or needs medication. For those who do, safe and effective FDA-approved medications are available for the treatment of alcohol use disorder, opioid use disorder, and tobacco/ nicotine use disorder. In this column, we are focusing on MAT for opioid use disorder (OUD). MAT for OUD is safe and considered the best practice in the treatment of most patients with OUD, including pregnant women. The three FDA-approved medications for OUD are buprenorphine (Suboxone), methadone, and naltrexone.
Why is MAT being offered in prisons?
Studies have shown that MAT significantly reduces the risk of relapse and overdose from opioids. Up to 80 percent of incarcerated people have a SUD, and opioid users are at high risk of death or harm from overdose during incarceration and upon release. According to data from the Bureau of Justice Statistics, from 2001 to 2018, the number of deaths from drug or alcohol intoxication in state prisons increased more than 600%. In 2019, 64 people incarcerated in CDCR died from overdose, making it the second leading cause of death.
Overdose is the number one cause of death upon release from prison. If individuals with OUD are stable on MAT when they are released, they are less likely to experience a fatal overdose after their release, even if they use opioids.
Isn’t MAT just “swapping one addiction for another”?
This is a common misconception. People with long-term opioid use may have permanent brain chemistry changes — for some, this might mean they need MAT in order to feel normal and avoid withdrawals. MAT works by normalizing your brain chemistry to reduce cravings and withdrawal symptoms. This allows people to function normally in their everyday lives.
I’m currently on MAT in prison. How do I continue treatment in the community after my release?
If you are on MAT already, you will receive 30-days of medication upon release. Nevertheless, it’s best to get connected to care as soon as possible. First, you need to activate your Medi-Cal health insurance through your county. It will take some time to go through this process: find a healthcare provider in the community who can prescribe MAT, make an appointment, meet the provider, and get your medications from the pharmacy. You may also have difficulties picking up medications if your insurance is not yet active. Instead of waiting until you are almost out of medications, it’s best to start this process right away to avoid disruptions in your treatment.
If you are currently being prescribed MAT in the prison, you should receive a treatment plan with information about where and how to continue MAT in your community. This will be given to you by the ISUDT nursing staff. If you do not receive this information or would like to speak with our staff about how to connect to care in the community, call our TCN Reentry Health Hotline at 510-640-6000.
Why am I being released with Naloxone?
Naloxone or “narcan” is an FDA-approved medication that can stop and reverse opioid overdose. CDCR is providing Naloxone and overdose prevention training to everyone releasing from prison. The risk of death from opioid overdose for people recently released is 129 times higher than the general population. This is due to factors including fentanyl in the drug supply and having decreased drug tolerance. Having naloxone ready to use is an important tool in preventing fatal overdose for you or others. You can also reduce your risk of overdose by testing — using a little bit of a drug first — having others around who can administer naloxone if needed, and calling emergency medical services in the event of overdose.
Where can I find MAT treatment in the community?
MAT is covered by health insurance and can be found in many places, such as opioid treatment programs, needle exchange programs, emergency rooms, or primary care clinics. Some primary care clinics have on-site MAT services while others do not. When you call a clinic to make an appointment, ask if they have a healthcare provider who will be able to prescribe the specific medication you are taking and if they take your insurance.
How will I pay for MAT in the community?
MAT services are an “essential health service.” These medications and related doctor’s visits are paid for through insurance, including Medi-Cal. Most people leaving prison are eligible for Medi-Cal.
Is there someone who can help me find a MAT provider in the community?
If you did not receive information from ISUDT or that information is not accurate, call the TCN Reentry Health Hotline to speak with a formerly incarcerated community health worker. We will answer some of your questions about healthcare in reentry and help you find a MAT provider in your community of return.
We’re thrilled to be able to communicate with the incarcerated community. We will be talking about many different topics, such as health insurance, MAT, prevention and treatment for Hepatitis C, HIV, defining and finding gender-affirming care, managing chronic conditions, and much more. But most importantly, we want to answer YOUR questions. If you have healthcare-related questions about reentry, feel free to write us at:
JPAY Email: TCNinfo@ucsf.edu
Mailing Address: Transitions Clinic Network, 2401 Keith Street, San Francisco, CA 94124