MEDICATION ASSISTED TREATMENTS

Medication Assisted Treatment (MAT) is defined as the use of FDA- approved medications in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to the treatment of substance use disorders. Research demonstrates a dramatic increase in efficacy of treatment and long term sustainable success when MAT is properly integrated into treatment. We specialize in all FDA approved Medication Assisted Treatment protocols including: Sublocade Injections (Monthly Buprenorphine Injections), Suboxone, Probuphine Implants, Vivitrol, Chantix and Nicotine Replacement. We also provide Ketamine Infusions for both Chronic Pain and Severe Depression. Additionally, we provide a full range of psychopharmacological treatment options for both addiction and co-occurring psychiatric disorders.
In February 2018, SAMHSA published new treatment improvement protocols focusing on the utilization of medicated assisted treatment (MAT). HHS Secretary Alex Azar III publicly touted MAT as a crucial component of stemming the crisis. Azar went on to say, “Medication-assisted treatment works,” “The evidence on this is voluminous and ever growing.” By referencing that only about one-third of speciality substance abuse treatment programs offer MAT, Secretary Azar said that failing to do so, “is like trying to treat an infection without antibiotics.

Our staff of board certified Physicians, Psychiatrists and Clinicians provide therapies specially designed to optimize your chance of success. Ketamine infusion therapy has shown to be a fast acting treatment for psychiatric disorders, including, Major Depression, Bi-Polar Depression, PTSD (Post Traumatic Stress Disorder), and OCD (Obsessive Compulsive Disorder). Recent scientific literature has demonstrated that approximately 60-80% of patients can experience significant improvement in their symptoms within hours.

We Specialize in all FDA approved Medication Assisted Treatments

HHS Secretary Alex Azar III publicly touted MAT as a crucial component of stemming the crisis. Azar went on to say, “Medication-assisted treatment works,” “The evidence on this is voluminous and ever growing.” By referencing that only about one-third of speciality substance abuse treatment programs offer MAT, Secretary Azar said that failing to do so, “is like trying to treat an infection without antibiotics.

What is Sublocade?
Sublocade is an injectable form of buprenorphine recently approved by the FDA. Whereas buprenorphine, or Suboxone, is typically taken under the tongue daily, Sublocade is taken as an injection once a month. This provides a steady dose of the drug with no need for daily maintenance.
What is buprenorphine used for?
Buprenorphine is used to treat dependence/addiction to opioids (narcotics). Buprenorphine belongs to a class of drugs called mixed opioid agonist-antagonists. It helps prevent withdrawal symptoms caused by stopping other opioids.

Suboxone

In layman’s terms, Suboxone is a compound that is made of two basic components. One of those is buprenorphine, and the other is naloxone. Buprenorphine is the opioid part of Suboxone, however offers a patient “less euphoria and physical dependence,” than medical opioids, according to the NAABT. The brain recognizes it as an opioid, so the body doesn’t experience the tense withdrawal symptoms that it would experience without any opioids at all.

The other half of Suboxone, naloxone, blocks the effects of an opioid when it is absorbed by the body. It isn’t absorbed well in the mouth, so Suboxone can be ingested orally and be recognized as an opioid. However, if Suboxone is used in any other way, such as through injection, naloxone blocks the brain from recognizing buprenorphine and the user does not receive a high, and instead triggers typical withdrawal symptoms associated with opioids. Because of its potency in preventing opioids from being absorbed by the brain, it is also used frequently to help someone who is in the middle of an overdose.

A Careful Solution For A Nationwide Opioid Epidemic

Giving Suboxone in detox to an opioid addict might seem like prescribing sugar to someone who is a diabetic. Despite the fact that it may seem like one of the components that caused the original problem, weaning someone off in safe and professional setting is the best way to begin life without drugs or opioids at all. By the end of treatment, patients will not be any substances whatsoever, having detoxed off of their origin substance and having too eliminated their need for Suboxone. Patients that properly complete Suboxone detox end up drug free.

Suboxone is the milder choice among many dangerous narcotics, and when administered carefully, can make detox far less difficult. It is a step in the right direction, not a step in the wrong direction. Remember, addiction is not entirely physical. An important aspect of defeating addiction comes after detox – rehab. Attending rehab is a process of learning how to cope with triggers and developing relationships and support, which will help prevent relapse and falling into the same habits. Detox is the physical component and is critical to ensuring rehab is successful – Suboxone is simply a carefully administered method to make that process more comfortable.

Vivitrol Injector Program

Naltrexone was first approved to treat opiate dependence in 1984, and in 1994 it was approved to treat alcohol dependence. Vivitrol, an intra-muscular, long-acting, injectable form of naltrexone, was developed in 2005 and FDA approved to treat alcohol dependence in 2006. It was approved to treat opiate dependence in 2010.

(Please see Appendix I for statistics regarding the scope of the addiction epidemic particularly as it pertains to opiate use and alcohol use in The United States.)

Substance Use Disorders have taken a heavy medical and economic toll on our society. We are in the midst of a serious public health epidemic as evidenced by the fact that drug overdose represents the number one cause of accidental death in America. As the DEA has clamped down on the ability to obtain illicit painkillers on the street, many users have turned to heroin as an alternative as it is cheaper and easier to obtain.

Patient populations that are especially affected by substance use disorders include:

Inmates with substance use disorders (and/or co-occuring psychiatric disorders) who are being released from state and/or federal prison and are on parole requiring abstinence as a condition of release;

Patients with co-occuring psychiatric/substance use disorders who are mandated to Assisted Outpatient Treatment (AOT), and must remain abstinent in order to remain in the community

Patients who are treated under NY State Diversion Programs, e.g. TASC, who require long-term abstinence in order to avoid incarceration;

Patients enrolled in long-term residential programs (e.g. Services for The Undersreved (SUS), Samaritan Village, etc…) who want to remain abstinent.

These patients require long-term abstinence from drugs and alcohol in order to remain stable, and thus able to survive in the community. In most cases, once these patients return to substance use, they are either hospitalized or re-incarcerated, either as a condition of parole/AOT requirements, or due to deleterious behaviors associated with substance use.

One of the challenges facing these patients is how to make sure that they are provided comprehensive, FDA approved medication assisted treatment (MAT) for substance use disorders – so that they have the best chance of success remaining abstinent in the community.

A successful Vivitrol Injector Program or “VIP” can address this pressing issue and will have significant medical, psychosocial and economic benefits once implemented.

Our program identifies and treat patients in New York State who are suffering from substance use disorders who:

  • Are being released from prison into the community on parole and/or;
  • Are mandated to participate in AOT, and suffer from a substance use disorder.
  • Are participating in drug-diversion programs
  • Are in long-term residential programs

The goal of our program is to demonstrate that successful implementation of a Vivitrol Injector Program will:

  • Decrease re-incarceration rates among inmates with substance use disorders who are released into the community and on parole;
  • Decrease re-hospitalization rates among patients mandated to AOT in New York State;
  • Reduce re-incarceration rates among patients in diversion programs;
  • Lengthen periods of abstinence, and reduce re-hospitalization/arrest rates among patients in long-term residential programs.

Our program is under the co-direction of Ramesh Sawhney, M.D. and Scott Bienenfeld, M.D., FAPA, who is certified by The American Board of Addiction Medicine (ABAM). The main location of our site is at 67 Irving Place, in Manhattan. At that location, we have the capacity to treat up to about 80-100 patients per week. We also have sites throughout New York City and Long Island; hence we have the capacity to treat large numbers of patients who require it. We also have the capability to reach out to agencies and provide on-site Vivitrol injections.

We maintain relationships with referring agencies/providers and require that patients receiving Vivitrol injections from our program remain in treatment with their referring provider(s)/agencies. We track all patient data, and ensure that they are followed up with regularly, and that they receive Vivitrol injections every 28 days.

Not only do we make it safe and easy for patients to receive Vivitrol injections, but we also provide direct follow-up and communication with each agency to make sure that clinical care is coordinated. We provide a unified, cohesive program that eliminates the hassle of dealing with Medicaid and commercial payers (we handle all of that). Essentially, we handle everything so that patients receive Vivitrol every 28 days with minimal hassle.

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