Medication Assisted Treatment

Suppose it is determined that MAT is appropriate. In that case, Opiate Use Disorder patients commence with the Induction Phase. They are assisted with the transition from their substance of abuse onto a buprenorphine product (1 to 3 days of frequent office visits).

This is followed by a Stabilization Phase, where the patient is seen regularly, and an optimal dose of the buprenorphine is determined.

Then follows the Maintenance Phase, where the medication is continued over time. Monitoring takes place weekly initially, then is slowly tapered at a minimum monthly.

Visits include a review of their assessment progress, urine drug screens (UDS), prescription database review, progress in therapy, etc. Duration of the maintenance phase is individualized, depending on improvement in treatment and social function. Other key factors involve weighing the relapse risks and anticipated level of morbidity and mortality with relapse in this patient.

When the maintenance phase is deemed completed, the patient enters the Discontinuation Phase. The buprenorphine is slowly tapered, with possibly other supportive medications to ease the potential withdrawal symptoms. At this point, other relapse prevention medications can be considered, such as Naltrexone/Vivitrol. Therapy and monitoring are typically increased during and shortly after this vulnerable phase.