Improving Public Health Through Access to and Utilization of Medication Assisted Treatment

Division of Pharmacologic Therapies, Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, 1 Choke Cherry Road, Rockville, MD 20857, USA.
International Journal of Environmental Research and Public Health (Impact Factor: 2.06). 10/2011; 8(10):4102-17. DOI: 10.3390/ijerph8104102
Source: PubMed


Providing access to and utilization of medication assisted treatment (MAT) for the treatment of opioid abuse and dependence provides an important opportunity to improve public health. Access to health services comprising MAT in the community is fundamental to achieve broad service coverage. The type and placement of the health services comprising MAT and integration with primary medical care including human immunodeficiency virus (HIV) prevention, care and treatment services are optimal for addressing both substance abuse and co-occurring infectious diseases. As an HIV prevention intervention, integrated (same medical record for HIV services and MAT services) MAT with HIV prevention, care and treatment programs provides the best "one stop shopping" approach for health service utilization. Alternatively, MAT, medical and HIV services can be separately managed but co-located to allow convenient utilization of primary care, MAT and HIV services. A third approach is coordinated care and treatment, where primary care, MAT and HIV services are provided at distinct locations and case managers, peer facilitators, or others promote direct service utilization at the various locations. Developing a continuum of care for patients with opioid dependence throughout the stages MAT enhances the public health and Recovery from opioid dependence. As a stigmatized and medical disenfranchised population with multiple medical, psychological and social needs, people who inject drugs and are opioid dependent have difficulty accessing services and navigating medical systems of coordinated care. MAT programs that offer comprehensive services and medical care options can best contribute to improving the health of these individuals thereby enhancing the health of the community.

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    • "Methadone maintenance therapy (MMT) is recognized by the U.S. Institute of Medicine as well as by the World Health Organization (WHO) to reduce cravings for illicit opioids, reduce crime linked to drug use, reduce deaths from overdose, reduce HIV risk behaviors, and help patients stabilize their lives and sustain productive activity [3,4]. Since 2002, buprenorphine has also been authorized for treatment of opioid dependence in the U.S. and is in wide use [5]. Methadone and buprenorphine are included for their therapeutic use on the WHO Model List of Essential Medicines [6]. "
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