TeleMAT is the combination of telehealth services and Medication-Assisted Treatment (MAT) with Buprenorphine for Opioid Use Disorder (OUD) patients. [1] [2]
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the term “MAT” refers to the "use of medications, in combination with counseling and behavioral therapies, to provide a ‘whole-patient’ approach to the treatment of substance use disorders.” The administration also notes the importance of addressing other health conditions during treatment. [3]
The U.S. Department of Health and Human Services (HHS) defines Telehealth, or telemedicine, as a course of care that “lets your health care provider provide care for you without an in-person office visit. Telehealth is done primarily online with internet access on your computer, tablet, or smartphone." [4]
In 2019, the term “TeleMAT” was coined by the QuickMD team to refer to the service of providing MAT to patients via telehealth. [5] [6]
The Substance Abuse and Mental Health Services Administration is a branch of the U.S. Department of Health and Human Services. SAMHSA is charged with improving the quality and availability of treatment and rehabilitative services in order to reduce illness, death, disability, and the cost to society resulting from substance abuse and mental illnesses. The Administrator of SAMHSA reports directly to the Secretary of the U.S. Department of Health and Human Services. SAMHSA's headquarters building is located outside of Rockville, Maryland.
Opioid use disorder (OUD) is a substance use disorder characterized by cravings for opioids, continued use despite physical and/or psychological deterioration, increased tolerance with use, and withdrawal symptoms after discontinuing opioids. Opioid withdrawal symptoms include nausea, muscle aches, diarrhea, trouble sleeping, agitation, and a low mood. Addiction and dependence are important components of opioid use disorder.
Buprenorphine, sold under the brand name Subutex among others, is an opioid used to treat opioid use disorder, acute pain, and chronic pain. It can be used under the tongue (sublingual), in the cheek (buccal), by injection, as a skin patch (transdermal), or as an implant. For opioid use disorder, it is typically started when withdrawal symptoms have begun and for the first two days of treatment under direct observation of a health-care provider.
Telehealth is the distribution of health-related services and information via electronic information and telecommunication technologies. It allows long-distance patient and clinician contact, care, advice, reminders, education, intervention, monitoring, and remote admissions. Telemedicine is sometimes used as a synonym, or is used in a more limited sense to describe remote clinical services, such as diagnosis and monitoring. When rural settings, lack of transport, a lack of mobility, conditions due to outbreaks, epidemics or pandemics, decreased funding, or a lack of staff restrict access to care, telehealth may bridge the gap as well as provide distance-learning; meetings, supervision, and presentations between practitioners; online information and health data management and healthcare system integration. Telehealth could include two clinicians discussing a case over video conference; a robotic surgery occurring through remote access; physical therapy done via digital monitoring instruments, live feed and application combinations; tests being forwarded between facilities for interpretation by a higher specialist; home monitoring through continuous sending of patient health data; client to practitioner online conference; or even videophone interpretation during a consult.
Telenursing refers to the use of information technology in the provision of nursing services whenever physical distance exists between patient and nurse, or between any number of nurses. As a field, it is part of telemedicine, and has many points of contacts with other medical and non-medical applications, such as telediagnosis, teleconsultation, and telemonitoring. The field, however, is still being developed as the information on telenursing isn't comprehensive enough.
A methadone clinic is a medical facility where medications for opioid use disorder (MOUD) are dispensed-—historically and most commonly methadone, although buprenorphine is also increasingly prescribed. Medically assisted drug therapy treatment is indicated in patients who are opioid-dependent or have a history of opioid dependence. Methadone is a schedule II (USA) opioid analgesic, that is also prescribed for pain management. It is a long-acting opioid that can delay the opioid withdrawal symptoms that patients experience from taking short-acting opioids, like heroin, and allow time for withdrawal management. In the United States, by law, patients must receive methadone under the supervision of a physician, and dispensed through an Opioid Treatment Program (OTP) certified by the Substance Abuse and Mental Health Services Administration and registered with the Drug Enforcement Administration.
Telepsychiatry or telemental health refers to the use of telecommunications technology to deliver psychiatric care remotely for people with mental health conditions. It is a branch of telemedicine.
An intensive outpatient program (IOP), also known as an intensive outpatient treatment (IOT) program, is a structured non-residential psychological treatment program which addresses mental health disorders and substance use disorders (SUDs) that do not require detoxification through a combination of group-based psychotherapy, individual psychotherapy, family counseling, educational groups, and strategies for encouraging motivation and engagement in treatment. IOP operates on a small scale and does not require the intensive residential or partial day services typically offered by the larger, more comprehensive treatment facilities.
Home automation for the elderly and disabled focuses on making it possible for older adults and people with disabilities to remain at home, safe and comfortable. Home automation is becoming a viable option for older adults and people with disabilities who would prefer to stay in the comfort of their homes rather than move to a healthcare facility. This field uses much of the same technology and equipment as home automation for security, entertainment, and energy conservation but tailors it towards old people and people with disabilities.
The Drug Addiction Treatment Act of 2000, Title XXXV, Section 3502 of the Children's Health Act, permits physicians who meet certain qualifications to treat opioid addiction with Schedule III, IV, and V narcotic medications that have been specifically approved by the Food and Drug Administration for that indication.
Treatment Improvement Protocols (TIPs) are a series of best-practice manuals for the treatment of substance use and other related disorders. The TIP series is published by the Substance Abuse and Mental Health Services Administration (SAMHSA), an operational division of the U.S. Department of Health and Human Services.
Substance abuse prevention, also known as drug abuse prevention, is a process that attempts to prevent the onset of substance use or limit the development of problems associated with using psychoactive substances. Prevention efforts may focus on the individual or their surroundings. A concept that is known as "environmental prevention" focuses on changing community conditions or policies so that the availability of substances is reduced as well as the demand. Individual Substance Abuse Prevention, also known as drug abuse prevention involves numerous different sessions depending on the individual to help cease or reduce the use of substances. The time period to help a specific individual can vary based upon many aspects of an individual. The type of Prevention efforts should be based upon the individual's necessities which can also vary. Substance use prevention efforts typically focus on minors and young adults – especially between 12–35 years of age. Substances typically targeted by preventive efforts include alcohol, tobacco, marijuana, inhalants, coke, methamphetamine, steroids, club drugs, and opioids. Community advocacy against substance use is imperative due to the significant increase in opioid overdoses in the United States alone. It has been estimated that about one hundred and thirty individuals continue to lose their lives daily due to opioid overdoses alone.
Drug detoxification is variously construed or interpreted as a type of “medical” intervention or technique in regards to a physical dependence mediated by a drug; as well as the process and experience of a withdrawal syndrome or any of the treatments for acute drug overdose (toxidrome). The first definition however, in relation to substance dependence and its treatment is arguably a misnomer and even directly contradictory since withdrawal is neither contingent upon nor alleviated through biological excretion or clearance of the drug. In fact, excretion of a given drug from the body is one of the very processes that leads to withdrawal since the syndrome arises largely due to the cessation itself and the drug being absent from the body; especially the blood plasma, not from ‘leftover toxins’ or traces of the drug still being in the system.
Telepharmacy is the delivery of pharmaceutical care via telecommunications to patients in locations where they may not have direct contact with a pharmacist. It is an instance of the wider phenomenon of telemedicine, as implemented in the field of pharmacy. Telepharmacy services include drug therapy monitoring, patient counseling, prior authorization and refill authorization for prescription drugs, and monitoring of formulary compliance with the aid of teleconferencing or videoconferencing. Remote dispensing of medications by automated packaging and labeling systems can also be thought of as an instance of telepharmacy. Telepharmacy services can be delivered at retail pharmacy sites or through hospitals, nursing homes, or other medical care facilities.
Buprenorphine/naloxone, sold under the brand name Suboxone among others, is a fixed-dose combination medication that includes buprenorphine and naloxone. It is used to treat opioid use disorder, and reduces the mortality of opioid use disorder by 50%. It relieves cravings to use and withdrawal symptoms. Buprenorphine/naloxone is available for use in two different forms, under the tongue or in the cheek.
The American Academy for Addiction Psychiatry (AAAP) is a professional organization and an accredited Continuing Medical Education (CME) provider, based in East Providence, Rhode Island, USA. Its members are specialists in addiction psychiatry and other health care professionals who treat patients with addictions. AAAP provides medical education programs in the field of addiction psychiatry.
Opioid agonist therapy (OAT) is a treatment in which prescribed opioid agonists are given to patients who live with Opioid use disorder (OUD). The benefits of this treatment include a more manageable withdrawal experience, cognitive improvement, and lower HIV transmission. The length of OAT varies from one individual to another based on their physiology, environmental surroundings, and quality of life.
Telehealth is the practice of providing healthcare via communication between the healthcare practitioner and the patient through electronic (virtual) methods such as telephones, smartphones, tablets, and computers. Telehealth permits patients to communicate with professionals via telephone, secure email, video chat, and in some instances secure messaging. Physicians may also utilize the telehealth systems for remote monitoring of patients at home. When the telehealth industry was founded, it was primarily used to provide services to underserved and rural area patients, enabled people to connect to specialists not located nearby. Telehealth was initially used predominantly for specialties such as cardiology, neurology, mental health, and dermatology. Telehealth has expanded to include many new applications such as physical therapy through digital monitoring tools and surgery done remotely using robots. The first major telehealth company, Teladoc, was founded in 2002 and since then the industry has grown to include companies such as Amwell, MeMD, and iCliniq.
Harm reduction consists of a series of strategies aimed at reducing the negative impacts of drug use on users. It has been described as an alternative to the U.S.'s moral model and disease model of drug use and addiction. While the moral model treats drug use as a morally wrong action and the disease model treats it as a biological or genetic disease needing medical intervention, harm reduction takes a public health approach with a basis in pragmatism. Harm reduction provides an alternative to complete abstinence as a method for preventing and mitigating the negative consequences of drug use and addiction.
The Modernizing Opioid Treatment Access Act is a proposed United States congressional bill introduced in the 118th United States Congress. Introduced in response to the national opioid epidemic, the legislation would expand access to methadone, an approved medication for treating opioid use disorder (OUD).