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What is Medication Assisted Treatment (MAT)?
What is Medication Assisted Treatment (MAT)?
Medication-assisted treatment (MAT) is the use of medications, in combination with counseling and behavioral therapies, to provide a "whole-patient" approach to the treatment of substance use disorders. Medications used in MAT are approved by the Food and Drug Administration (FDA) and MAT programs are clinically driven and tailored to meet each patient’s needs (SAMHSA, 2021).
MAT medications, such as buprenorphine, methadone and naltrexone, are used to treat opioid dependence and alcohol use disorder
Why is MAT so Important in Pennsylvania
Why is MAT so Important in Pennsylvania
Every 16 minutes a person in the United States dies from a drug overdose (CDC, 2016)
In 2019 more than 70,000 Americans died from drug-related overdose (CDC, 2021)
In 2018 4,491 people died in Pennsylvania due to drug overdose which is a rate of 35 deaths per 100,000 people (CDC, 2021)
Between 2014-2018 there was a 36% increase in drug-related overdose deaths
Opioid misuse, dependence and overdose cost the United States $78 million in health care, criminal justice and lost productivity costs (Curtis et al, 2016)
Pennsylvania MAT Shortage Areas
Pennsylvania MAT Shortage Areas
Adapted from (Department of Health and Human Services, 2020)
Benefits of MAT
Benefits of MAT
MAT reduces opioid overdose death (Schwartz et al, 2016)
MAT reduces the transmission of infectious diseases, like HIV and Hepatitis C (Schwartz et al, 2016)
Patients who use MAT stay in treatment longer (Schwartz et al, 2016)
MAT reduces healthcare costs with (Florence et al, 2016)
MAT is Underutilized
MAT is Underutilized
Despite the benefits of MAT, 90% of people in need of addiction treatment do not have access to treatment (AMA, n.d.)
53% of counties in the US do not have a provider with waiver to prescribe buprenorphine (PEW Charitable Trusts, 2017)
Stigma and travel to clinics are cited as the biggest barriers to patients accessing MAT (Holt et al, 2019)
What Does this Have to do with Midwives?
What Does this Have to do with Midwives?
Although men are still more likely to die due to an opioid overdose, opioid-related deaths are increasing among women
Women ages 25-54 are the most likely to visit an emergency department related to opioid misuse or overdose
Models of care in Vermont and the Veterans Administration in Ohio have demonstrated that taking MAT out of "the clinic" and into a patient centered primary care model reduces stigma and makes MAT more accessible. This reduces healthcare costs and overuse of emergency services (Holt et al, 2019)
As primary care providers for women across the lifespan, midwives are well positioned to be MAT providers.
Opioid dependence is associated with an increase risk of low birth weight, neonatal abstinence syndrome, neonatal mortality, and poorer maternal outcomes. MAT improves pregnancy outcomes. (ACNM, n.d.)
The Substance Use Disorder Prevention that Promotes Opioid Recovery for Patients and Communities Act (SUPPORT ACT) enacted in October 2018 updated language from the 2016 Comprehensive Addiction and Recovery Act (CARA) to include Certified Nurse Midwives among the providers who can prescribe MAT
The American College of Nurse Midwives supports midwives prescribing MAT (ACNM, n.d.)
Despite this national legislation and endorsement from ACNM making CNMs approved providers to provide MAT, Pennsylvania's current prescriptive authority laws have discouraged midwives from prescribing these life saving medications
If passed, the Midwifery Modernization Bill will allow for Pennsylvania board-certified midwives to prescribe MAT!
If passed, the Midwifery Modernization Bill will allow for Pennsylvania board-certified midwives to prescribe MAT!
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