Medication-assisted treatment (MAT) is a more effective treatment option for addictions to certain drugs, such as opioids and alcohol.
However, it is expensive and not always entirely covered by insurance. Many people who could benefit from MAT may have problems covering the cost of treatment.
Medication-assisted treatment refers to any chemical dependency program that uses medication to assist in combating that dependency. Medication is almost always used in conjunction with other non-medication treatments, like therapy.
MAT is a term that is most often, but not exclusively, applied to opioid addiction treatment.
Broadly speaking, MAT is superior in effectiveness to treatments that do not use medications to help clients. The exact efficacy can be difficult to determine with many studies contradicting each other. The general consensus is such treatments are statistically more likely to help than a purely non-medication treatment.
There is a balancing act in play; however, as the drugs used are often expensive. State governments, insurance companies, and individuals cover the costs.
Unfortunately, some people who would benefit from MAT might be unable to pay their portion.
The Substance Abuse and Mental Health Services (SAMHSA) outlines how insurance coverage for MAT sometimes works. The matter is complex.
Generally, insurance companies will cover some or all of the cost of at least a few medication-assisted treatment options. Certain drugs may be unavailable on specific plans, or they might cap out at certain dosages or refills. Depending on the person, their needs may or may not be met.
In order to be covered, MAT must be deemed “medically necessary.” This generally means that the person must be struggling with addiction to a particular type of drug — usually opioids, but in some cases, MAT may be covered for addiction to alcohol.
Some people may find MAT is deemed medically unnecessary by their insurance. As a result, they will be denied any coverage whatsoever. They can appeal this decision, but the process can be lengthy.
Specifically discussing opioid addiction treatments, the National Institute on Drug Abuse (NIDA) lists the average costs of three of the most common medications used for MAT in 2018.
A few things should be noted regarding this data. First, proper dosing and the methodology by which the drugs are administered varies. For example, the amount of methadone needed for an average week’s worth of doses is not the same as a week’s worth of buprenorphine.
Second, NIDA notes some average costs of comparatively expensive conditions. Diabetes mellitus can cost a patient $3,560, and kidney disease can cost a patient $5,624 annually in medication costs, according to NIDA.
If a person is uninsured or has insurance that, for any reason, does not cover these costs, they may be unable to afford MAT. These people must pay out of pocket for the medications, and in reality, this is just too expensive for many. They may have to choose alternative treatment options (or none at all) for this reason.
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While exact costs will vary depending on a number of factors, such as location and chosen treatment center, treatment options that don’t utilize medications will generally be cheaper than MAT.
The reason for this is simple: Medication is generally expensive. Since most MAT includes therapy and other services, when you remove the medication component, the resulting program is cheaper even when the other services remain.
A 2009 study noted that methadone treatment costs a patient about $7,409 on average whereas a non-methadone outpatient treatment cost them an average of $2,325 to $4,271 for more intensive outpatient treatment. This study was complex and touched on a number of problems with the cost estimates given by the Center for Substance Abuse Treatment (CSAT).
Non-methadone treatments tended to be shorter programs (the length of time from entering a program to being discharged from it).
In regard to discrepancies in relation to the cost of methadone treatment, it should be noted the study used a different methodology than NIDA, and the study is outdated (meaning costs have likely changed). Also, the exact costs of treatments vary from region to region, and not all data is available to get a perfect estimate in any case.
For most people whose insurance will cover MAT over non-MAT, medication-assisted therapy will be preferable for addiction to certain drugs.
In their article Effective Treatments for Opioid Addiction, NIDA notes the efficacy of MAT. To make a large amount of sometimes conflicting data simple, MAT is shown to help people more than programs that do not use medications.
Many people reject MAT due to myths or misconceptions about medications being used to treat addiction and dependency.
These drugs are meant to assist, east and help in the recovery process.
While methadone is addictive, it is far safer than other opioids like heroin, and methadone is generally administered in a tightly controlled setting.
Medications can help wean people off drugs of addiction who would otherwise be unable to stop abusing drugs.
The unfortunate reality for some people, however, is that the cost of treatment is just too high. In the United States, it can be fairly expensive to receive any kind of treatment, and MAT is no exception.
If a person doesn’t have insurance, they can look into other options to fund MAT. In some cases, they may qualify for federal or state programs that fund MAT.
In the end, addiction and dependency will almost always be much more expensive than treatment.
Consistently needing to purchase drugs illegally risks jail time, and felony convictions will expose you to a constant drain on your income. This is in addition to the way drug addiction wears on the body and increases health care costs. Addiction also significantly affects your income and career potential in obvious ways.
While the United States is arguably in need of a system that makes MAT more affordable for those who need it, there are options available for those currently in need.
Medications can be a significant help in the treatment of addiction and a key stepping stone to recovery. Talk to a treatment professional about your options.
(February 13, 2019). Meperidine. Drug Bank. Retrieved February 2019 from https://www.drugbank.ca/drugs/DB00454
(January 2019) How Long Does Demerol Stay in Your System. HealthCentral. Retrieved February of 2019 from https://www.healthcentral.com/article/long-does-demerol-stay-system
(January 2019). 9 Types of Medication Older Adults Should Use with Caution. AARP. Retrieved February 2019 from https://www.aarp.org/health/drugs-supplements/info-07-2011/medications-older-adults-should-use-with-caution.html
(January 2019). What is Kidney (Renal) Failure? Urology Care Foundation. Retrieved February 2019 from https://www.urologyhealth.org/urologic-conditions/kidney-(renal)-failure
(July 12, 2018). What a Medication’s Half-life Can Mean For You. Verywell Mind. Retrieved February 2019 from https://www.verywellmind.com/medication-half-life-380031
(January 2017). Aspirin Journey through the body – 3D Animation. Sheffield Hallam University. Retrieved February 2019 from https://www.youtube.com/watch?v=Jiml3iGBs88&list=PL4C__diu9TfzbU4TG_JsFKAfwYoXdM7Gi
(September 23, 2016). How the Body Absorbs and Uses Medicine. Merck Manuals. Retrieved February 2019 from https://www.youtube.com/watch?v=IOf-z0D1mHk
(September 2011). Is Meperidine the Drug That Just Won’t Die? NCBI. Retrieved February 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3292527