MAT program

[IDNP]

Hello fellow Nurse Practitioners working in addiction medicine,

Our clinic is interested in offering MAT services. We have behavioral health providers and I have obtained my DATA waiver, . I am looking for insights and feedback from others who have worked in MAT. I have familiarize myself with the Samhsa site and have the MAT book and pocket guide. I am more specifically looking to hear how other providers are running their MAT practice.

1) What is your criteria/conditions to accept patients into your MAT program? besides opioid dependence and desire to quit using obviously. For instances, if they have poly substances abuse disorder and want to continue using other substances? alcohol, lsd or other substances.

2) What is your process for inductions? what medications do you have/use on site for withdrawal symptoms and to send patients home?

3)Which form of buprenorphine do you prefer to use, pill, sublingual, or other? and why?

4) How often do you see your MAT patients the first week and there after for maintenance?

5) do you also treat their co-morbid mental health conditions?

6) how often do you drug screen?

Any dos and don'ts

thanks

I appreciate all your feedback.

[glass_houseRN, BSN, MSN, RN]

Hi there! Nurse currently working in MAT. I see this post is from February but I have some input that may be helpful.

1) What is your criteria/conditions to accept patients into your MAT program? besides opioid dependence and desire to quit using obviously. For instances, if they have poly substances abuse disorder and want to continue using other substances? alcohol, lsd or other substances.

Criteria = any opiate dependence. They can be using other substances as well, but must be willing to quit. Any illicet drug use can (and will eventually) lead back to opiate use.

2) What is your process for inductions? what medications do you have/use on site for withdrawal symptoms and to send patients home?

Initiate on suboxone 4-8 mg depending on COWS or CINA score. Can give take home Vistaril for anxiety, clonidine for restlessness, bentyl for stomach cramps, Zofran for nausea.

3) Which form of buprenorphine do you prefer to use, pill, sublingual, or other? and why?

Doesn't really matter. Pt preference. All have the blocker. If the pt really gets it in their mind to try and abuse it and inject it, they will try regardless of the form.

4) How often do you see your MAT patients the first week and there after for maintenance?

Our providers see them weekly the first 2 months until at least their IOP is completed.

5) do you also treat their co-morbid mental health conditions?

I am not sure what our providers do, but I feel that you should. If their mental health conditions are not properly treated, relapse is more likely (if not inevitable). At the very least, refer out and have them get treatment somewhere.

6) how often do you drug screen?

I would weekly for the first couple months at least, usually they drop once a week during their IOP course.