Enhanced Medication Assisted Treatment (MAT) Program at AdCare Rhode Island

Along with standard protocols for alcohol and opioid detox, AdCare Rhode Island has established a unique set of enhanced MAT protocols for patients suffering from Opioid Use Disorder (OUD). During inpatient treatment, individuals are provided with information and can initiate on MAT protocols that include Suboxone maintenance therapy, naltrexone/Vivitrol treatment, and methadone maintenance treatment.

“Our Enhanced MAT Program is leading the way in Rhode Island. Nearly eight out of ten or 77% of patients were inducted on MAT protocols in 2019. Some patients took advantage of the Rapid Methadone Detox to detox from methadone and transition to either Suboxone or Vivitrol over a four-week period. We also saw some patients that were doing well on Suboxone for one-to-two years elect to be weaned off the medication.” — Michael Coburn, MD, ABAM, Medical Director

Dr. Coburn Presented on MAT at the MA/RI EAPA Showcase Meeting on December 13, 2019. He highlighted the benefits and risks of MAT and offered tips for matching clients with the most appropriate MAT, counseling, and recovery supports.

Rapid Methadone Detox and Rapid Suboxone Detox

At AdCare Rhode Island, patients on high doses of methadone for long periods of time have the opportunity to rapidly detox and transition to either Suboxone or Vivitrol over a four-week period; the standard protocol for methadone detox can take a patient on 150 ml. of methadone one-to-two years to detox. Our Rapid Methadone Detox gives patients on high doses of methadone for long periods of time the opportunity to detox and transition to either Suboxone or Vivitrol over a four-week period. As a result, more patients are opting to rapidly detox from methadone and convert to a MAT that better suits their lifestyle and goals. “The injectable buprenorphine sublocade allows for a slow taper over a shorter period of time and takes the decision making and work of pill reduction out of the patient’s hands,” said Dr. Coburn. Consequently, patients tend to be more compliant and successful detoxing off Suboxone.

Effectiveness of Suboxone, Vivitrol, and Counseling

“Patients choosing MAT tend to be highly motivated and want to take advantage of the anti-craving and opioid-blocking medications available to help them maintain their sobriety,” said Dr. Coburn. Vivitrol, for example, is the brand name of an extended-release, once-a-month injection of naltrexone that completely blocks the intoxicating and pleasurable effects of opioids in the brains of individuals struggling with OUD. Vivitrol’s capacity to reduce drug cravings is also beneficial for people with Alcohol Use Disorder (AUD).

“When MAT is used with counseling and other recovery supports, a successful recovery is very likely,” stressed Dr. Coburn, referencing the early NIDA clinical trials study, Extended Suboxone Treatment Substantially Improves Outcomes for Opioid-Addicted Young Adults. Suboxone, a combination of buprenorphine and naloxone, helps people reduce or stop their use of opiates. The buprenorphine eases drug cravings, and the naloxone is included to deter misuse of the medication. Participants in the study who received Suboxone (buprenorphine-naloxone) and counseling for 12 weeks had substantially better outcomes than those who received the standard treatment of short-term detoxification combined with counseling.

Another NIDA clinical trials network study comparing buprenorphine/naloxone (Suboxone) to extended-release naltrexone (Vivitrol) — combined with up to 24 weeks of outpatient treatment — showed similar positive outcomes for both medications. The study also confirmed that people struggling with opioid dependence that follow detoxification with no medication are very likely to return to drug use.

Quality Clinical Program

The clinical team at AdCare Rhode Island utilizes evidence-based practices such as Motivational Enhancement Therapy (MET), Cognitive Behavioral Therapy (CBT), psycho-educational groups, and 12-step meetings to help individuals make healthy decisions and develop solid coping strategies around substance use, Therapeutic and recreational activities such as acupuncture, drumming, meditation, and yoga are also available to help support the permanent lifestyle changes needed to maintain a healthy long-term recovery.