MEDICATION OPTIONS

Community Medical Services provides medication-assisted treatment (MAT) for individuals with opioid use disorder. MAT uses a holistic approach to treat the “whole-patient” with the use of FDA-approved medications, counseling, and behavioral therapy. Medication helps to alleviate withdrawal and cravings, allowing the patient to focus on positive behavior changes.

There are 3 FDA-approved medications to treat opioid use disorder, methadone, buprenorphine, and naltrexone. The goal of MAT is to find the lowest possible dose of a medication that will relieve withdrawal symptoms and cravings for a 24-hour period. The medications used in MAT, at a stable dose, do not have any adverse effects on an individual’s ability to work, drive, care for their children, or otherwise live a healthy life.

Methadone

Buprenorphine (Suboxone®/Subutex®)

Naltrexone (Vivitrol®)

  • Long lasting, allows for daily dosing
  • Most affordable medication
  • Alleviates withdrawal symptoms, prevents cravings, and blocks euphoric effect of other opioids
  • No abstinence of opioids required prior to staring treatment
  • Synthetic opioid that attaches to the opioid receptor in the brain
  • Full agonist that fully activates the opioid receptor
  • Long lasting, allows for daily dosing
  • Good control of cravings and withdrawal
  • Alleviates withdrawal symptoms, prevents cravings, and blocks euphoric effect of other opioids
  • Synthetic opioid that attaches to the opioid receptor in the brain
  • Partial agonist that activates some of the opioid receptor
  • Long lasting injectable medication that is administered every 28 days
  • Requires 7-10 withdrawal of all opioid medications
  • Not recommended for pregnant women
  • Will not alleviate withdrawal symptoms
  • Antagonist that blocks all effects of the opioid receptor

Methadone:

  • Long lasting, allows for daily dosing
  • Most affordable medication
  • Alleviates withdrawal symptoms, prevents cravings, and blocks euphoric effect of other opioids
  • No abstinence of opioids required prior to staring treatment
  • Synthetic opioid that attaches to the opioid receptor in the brain
  • Full agonist that fully activates the opioid receptor

Buprenorphine (Suboxone®/Subutex®):

  • Long lasting, allows for daily dosing
  • Good control of cravings and withdrawal
  • Alleviates withdrawal symptoms, prevents cravings, and blocks euphoric effect of other opioids
  • Synthetic opioid that attaches to the opioid receptor in the brain
  • Partial agonist that activates some of the opioid receptor

Naltrexone (Vivitrol®)

  • Long lasting injectable medication that is administered every 28 days
  • Requires 7-10 withdrawal of all opioid medications
  • Not recommended for pregnant women
  • Will not alleviate withdrawal symptoms
  • Antagonist that blocks all effects of the opioid receptor

Choosing the right medication for you and your lifestyle is a decision made by you and your medical provider

COUNSELING

At CMS, we provide both individual and group counseling services to our patients. Through the use of evidence-based practices, counselors help clients to develop healthy coping strategies, individualized to their needs. Together, clients and counselors work on problem solving skills to address substance use.

PREGNANCY AND WOMEN’S HEALTH

At CMS, we recognize the unique healthcare needs of our female clients. Methadone or buprenorphine, along with evidence-based behavioral therapies, is recommended by the SAMHSA as the standard of care for treating pregnant women with OUD. CMS coordinates with OBGYN and other medical providers to ensure the highest quality of care.

Pregnancy & MAT

CMS offers a variety of services to help women who are pregnant. Our goal is to empower you as a leader in your recovery, with benefits to you and your baby. Methadone during pregnancy is considered the gold standard of care by the World Health Organization (WHO) and the American College of Obstetricians and Gynecologists. For most women with OUD, experts agree that the benefits of medications for OUD outweigh the potential risks. MAT is not harmful to the developing baby, and mothers are encouraged to continue with MAT throughout their pregnancy.

Benefits of MAT During Pregnancy

  • Improves nutrition for the mother, which increases the baby’s birth weight – women receiving MAT tend to have larger and healthier babies and are more likely to reach full-term deliveries than women receiving no treatment for their OUD
  • Enhances a woman’s ability to prepare for the birth
  • Reduces the risk of preterm birth and complications
  • Improves prenatal care and other rehabilitative efforts
  • Prevents fluctuations of the mother’s drug level that may occur, minimizing the risk of withdrawals for the baby in utero
  • Reduces illicit drug use and helps to remove opioid-dependent women from the drug-seeking environment

Neonatal Abstinence Syndrome (NAS)

Babies cannot be born “addicted” to opioids or any other substance. However, after delivery the baby will not receive as much medication from the mother and may experience fussiness, poor feeding, poor sleeping, and jitteriness – this is called neonatal abstinence syndrome (NAS). Not all babies have symptoms, and simple measures often get babies through them if they do occur – CMS offers a variety of resources to help educate new moms on helping their baby if they show signs of NAS. The risk of the baby having significant NAS symptoms is NOT related to the mother’s dose of medication. For most women, it is recommended to continue MAT during pregnancy; remaining on OUD medications is generally the safest choice for BOTH the mother and baby.

Stopping MAT during pregnancy may cause lower birth weight, increased complications, and a return to substance use, putting mother and baby at risk; tapering off MAT during pregnancy should be avoided if possible. Stopping opioids (and other substances) immediately may not be safe, particularly during pregnancy, due to the additional risk to the developing baby, who may also go through withdrawal. If you do decide to taper from MAT during pregnancy, you should only do so after consultation with medical professionals.

PEER SUPPORT

Peer Support Specialists at CMS are individuals with lived experience who have the ability to understand the challenges of substance use and recovery. They bring their unique perspective for overcoming challenges and navigating the treatment system.

CMS has integrated peer support into many aspects of our treatment services, including:

  • Correctional health
  • Hospital in-reach
  • Support groups
  • Community outreach and education
  • Pregnancy support and groups
  • Community partnership with local emergency medical services teams

CORRECTIONAL HEALTH

At CMS we believe that all people, regardless of incarceration status, deserve fair and equitable healthcare. Incarcerated individuals are at a greater risk for struggling with substance use; approximately 68% of people incarcerated meet the medical criteria for drug dependence. Moreover, studies indicate that 80 – 90% of individuals relapse within 30 days of release. To address this disparity, CMS collaborates with correctional health facilities to ensure all individuals have access to quality substance use treatment.

In 2010, CMS began supporting pregnant inmates with medication-assisted treatment in Maricopa County Jail and Arizona’s Perryville State Prison. Since then, Community Medical Services has expanded to treat all incarcerated populations and collaborates with federal and state prisons and/or jails in Alaska, Arizona, Montana, North Dakota, Ohio, Texas, and Wisconsin. We continue to develop correctional health programs across the country; each program is tailored to the unique needs of the specific city, county, and state. Programs can include the following:

  • Screening for OUD
  • In-reach peer support services and education
  • Pregnancy support services and education
  • Coordinate care to other community providers
  • Medication delivery and counseling services
  • Telehealth services

If you are interested in discussing a potential collaboration with your agency or organization, contact Michael White, Director of Community Programs at info@cmsgiveshope.com.