Medication Assisted Treatment (MAT) with Methadone (HCPCS G2067)

Name of the Procedure:

• Common Name: Methadone MAT
• Technical Term: Medication Assisted Treatment, Methadone; Weekly Bundle

Summary

Methadone MAT is a comprehensive treatment program for individuals struggling with opioid use disorder. It includes the weekly administration of methadone, which helps manage withdrawal symptoms and cravings, along with substance use counseling, individual and group therapy, and toxicology testing if needed.

Purpose

Medical Conditions Addressed:

• Opioid Use Disorder (OUD)

  Goals:

• Reduce withdrawal symptoms and cravings
• Support sobriety and recovery
• Improve overall mental health and functioning

Indications

Symptoms or Conditions:

• Dependence on opioids (heroin, prescription painkillers)
• Frequent relapses after detox or short-term treatment

Patient Criteria:

• Diagnosed Opioid Use Disorder
• Willingness to participate in a comprehensive treatment program

Preparation

Pre-Procedure Instructions:

• No specific fasting or dietary restrictions
• Follow any medication adjustments as advised by the healthcare provider

Diagnostic Tests:

• Initial assessment for opioid dependence
• Baseline urine toxicology screening

Procedure Description

1. Initial Assessment: Comprehensive evaluation of opioid use history and physical health.
2. Dispensing/Administering Methadone: Weekly dosing of methadone to control withdrawal symptoms.
3. Counseling Sessions: Regular substance use counseling to address behavioral aspects of addiction.
4. Therapy: Individual and group therapy sessions to support mental health and provide peer support.
5. Toxicology Testing: Periodic urine tests to monitor for substance use.

Tools and Equipment Used:

• Methadone medication
• Urine test kits for toxicology screening

Anesthesia or Sedation:

• Not applicable

Duration

• Weekly sessions (approximately 1 hour per session)

Setting

• Outpatient clinic or specialized substance abuse treatment center

Personnel

• Healthcare professionals including:
  • Physicians or nurse practitioners
  • Substance use counselors
  • Therapists (individual and group)
  • Medical assistants for toxicology testing

Risks and Complications

Common Risks:

• Methadone side effects (constipation, drowsiness, sweating)
• Risk of methadone dependence

Rare Complications:

• Respiratory depression if methadone dose is too high
• Potential for misuse or diversion of methadone

Management:

• Regular monitoring and dose adjustments
• Emergency protocols in place for severe side effects

Benefits

• Reduces withdrawal symptoms and cravings
• Supports long-term recovery and sobriety
• Enhances mental health and overall quality of life
• Benefits may be realized within weeks to months of starting treatment

Recovery

Post-Procedure Care:

• Ongoing participation in therapy and counseling
• Regular follow-up appointments for dose adjustments and progress monitoring

Recovery Time:

• Continuous, long-term treatment approach
• Duration depends on individual progress and recovery goals

Restrictions:

• Avoiding use of other opioids and illicit substances
• Adherence to treatment plan and clinic rules

Alternatives

Other Treatment Options:

• Buprenorphine (Suboxone) MAT
• Naltrexone (Vivitrol) MAT
• Abstinence-based programs

Pros and Cons of Alternatives:

• Buprenorphine: Less risk of overdose but may also cause dependence.
• Naltrexone: No opioid effects but requires complete detox before starting.
• Abstinence only: No medication side effects but higher relapse rates.

Patient Experience

• During Procedure: Varies from no sensation (methadone dosing) to emotional support (counseling/therapy).

• After Procedure: May experience relief from withdrawal symptoms and cravings; emotional and psychological support through therapy.

  Pain Management and Comfort:

• Non-opioid pain management strategies as needed
• Emotional support from healthcare team and peer groups