HJAR Mar/Apr 2020

44 MAR / APR 2020 I  HEALTHCARE JOURNAL OF ARKANSAS COLUMN MEDICAID MANY health care professionals are con- cerned about treatment with OUD medica- tions. Providers state that it could result in the patient replacing an opioid addiction with an OUD medication addiction. However, OUD medications are safe and effective when they are dispensed as part of MAT. Opioid use disorder is a chronic, treatable illness that requires long-term care management. With other chronic conditions like diabetes, clinicians would not stop providing care for a diabetic if the patient gained weight or was non-compliant with medications. Arkansas practitioners must start treating OUD as an- other long-term, treatable illness. One way to address concerns raised by physicians is to follow the guidance issued by the SubstanceAbuse Mental HealthAdminis- tration’s (SAMHSA) Treatment Improvement Protocol (TIP) 63. Because this is best prac- tice for providing MAT treatment, Medicaid uses SAMSHA guidelines when reviewing MAT services provided to enrolled clients. MAT is a relatively new treatment, and it is rapidly changing as new information comes to light; therefore, providers should always go by the most recent SAMHSA guidelines. Research has shown that when correctly ad- ministered, MAT can: • relieve withdrawal symptoms • reduce psychological cravings • assist patients in overcoming use of an abused opioid • reduce the risk of overdose death SAMHSAhas publishedmultiple resources on integrating MAT into daily practice. TIP 63 outlines and summarizes OUD screening, assessment, and referral. It recommends uni- versal OUD screening in primary care prac- tices due to the high prevalence of substance use disorders, and the effectiveness of medi- cations to treat OUD. TIP 63 also reviews three FDA-approved medications that can treat OUD and prevent relapse, including buprenorphine, metha- done, and naltrexone. Methadone can only be given for addiction at an Opioid Treatment Program (OTP), and Arkansas has six OTPs in the state located in Bentonville, Bryant, Jonesboro, Little Rock, North Little Rock, and Texarkana. Buprenorphine can be written for pain or addiction, but to write for addiction the provider must have an “X” DEA num- ber. Training for MDs, PAs, andAPRNs to get BEST PRACTICES inMedication Assisted Treatment for Opioid Use Disorder In May 2019, overdoses surpassed homicides for the leading cause of death for the first time in Arkansas. Unfortunately, overdoses continue to rise nationally and statewide. One of the most cutting-edge treatments for Opioid Use Disorder (OUD) is Medication Assisted Treatment (MAT), a Medicaid-approved option for those who are suffering from Opioid Use Disorder (OUD). The goal of MAT, or any treatment for OUD, is remission leading to lasting recovery.

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