Practice Tip of the Week: Medication-Assisted Treatment: The Gold Standard
Monday, October 21, 2019
Posted by: Roy Muyinza
By: Dawn Webb, RN & Kanaka Sathasivan, MPH
Opioid use disorder is lethal, but medication-assisted treatment is saving lives, including those of nurses. Unfortunately, the stigma attached to substance use disorders has carried into treatment with MAT. Numerous studies and news outlets have highlighted the lack of MAT at treatment facilities, which have emulated the abstinence-only models of treating alcohol use disorder. And a recent study showed that patients who requested MAT were met with resistance from their providers.
Treatment Across the US
This issue has received national press attention, and this month, both NPR and VICE looked into why doctors and nurses with opioid use disorder are often barred from using MAT when participating in peer assistance programs. VICE particularly stressed the effectiveness of MAT: “Clinical studies show medication treatment significantly decreases the rate of relapse and overdose more than other interventions alone, including abstinence models.”
Both investigations found that many peer assistance programs for nurses and doctors continue to follow abstinence-only models. In addition, these programs — including the Texas Peer Assistance Program for Nurses — have been historically considered punitive by participants and potential participants, partially due to abstinence requirements. Over the summer, TPAPN conducted focus groups and interviews and found the same perception among Texas nurses.
Treatment in Texas
Unlike the programs mentioned in the NPR and VICE investigations, TPAPN accepts the validity of MAT in assisting nurses in recovery. From TPAPN’s policy, Maintenance Opioid Therapy for Narcotic Addiction:
Many individuals recovering from substance use disorders can maintain abstinence with formal substance abuse treatment, self-help groups, and individual recovery programs. However, some individuals may require alternative and/or ancillary methods, and a closely supervised maintenance program of Medication-Assisted Therapy may be appropriate.
In addition, TPAPN has worked hard over the past few years to shift the perception that referrals to the program are punitive. Case managers train to provide person-centered care and support nurses. This includes respecting the treatment regimen prescribed by the participant’s treating physician, even if it includes MAT.
When a participant receives MAT, TPAPN requires a physician who holds a board certification in addiction medicine or addiction psychiatry by the American Board of Preventive Medicine or the American Board of Psychiatry and Neurology to ensure the participant is fit to practice nursing safely.
Nurses are human beings and deserve the best treatment for their situation, this varies from person to person and MAT is an effective treatment method for opioid addiction.
Or as TPAPN Case Management Team Lead Roland Rodriguez, LCDC, puts it: “We are not in the business of telling nurses what to take and what not to take; we leave that up to medically licensed and qualified physicians.”
If you or someone you know is struggling with substance use disorder or mental health issues, please contact TPAPN at 800-288-5528.