Treatment

NJ CARES

A Dashboard of Opioid-Related Data and Information

Kelly E. Levy,
Acting Director
  • Medications for Opioid Use Disorder (MOUD)
  • Common Misconceptions about MOUD
  • Questions about Coverage for Treatment
  • Finding an Opioid Use Disorder (OUD) Treatment Program Near You

 

Medications for Opioid Use Disorder (MOUD)

Treating people who suffer from opioid use disorder (OUD) with FDA-approved medications is a rational and effective evidence-based method to promote recovery and save lives.[1]  The most common medications used to treat OUD—or “MOUD”—are methadone, buprenorphine, and naltrexone.

All three medications operate to normalize brain chemistry, block the euphoric effects of alcohol and opioids, relieve physiological cravings, and normalize body functions without the negative and euphoric effects of the substance used.[2]   All three medications are safe to use for months, years, or even a lifetime.[3]   And all three medications are effective.[4]  The duration of treatment varies among patients—it may take months or years in some cases.  Just as body tissue requires prolonged periods to heal after an injury and may require external supports (e.g., a cast and crutches or a wheelchair for a broken leg), brain circuits that have been altered by prolonged drug use and substance use disorder take time to recover and benefit from external supports in the form of medication.[5]

Each of the three medications is administered in different ways:

  • Methadone is a long-acting opioid medication that is available as a pill, liquid, or injectable, and is administered once a day. It has been shown to reduce cravings and the symptoms of opiate withdrawal, and prevent the user from experiencing the euphoric effects of opiate drugs. And it has shown to be effective in retaining heroin users in treatment. Methadone may only be dispensed through a licensed clinic and in conjunction with an opioid treatment program (OTP).[6]
  • Buprenorphine is the first MOUD that can be prescribed or dispensed in a physician’s office, significantly increasing access to treatment with clear benefits to those for whom treatment in an opioid treatment clinic is not appropriate or convenient.[7]   It is available as a film, sublingual tablet, once monthly injectable, or an implant under the skin, and works similarly to methadone to diminish cravings and withdrawal symptoms. A practitioner licensed in New Jersey who has a current DEA registration that includes Schedule III authority, may now prescribe buprenorphine for OUD in his/her/their practice.[8]
  • Naltrexone blocks the effects of opioids by binding to opioid receptors, but unlike methadone and buprenorphine, it is not an opioid. Naltrexone is available in a pill, but only the monthly injectable formulation is FDA-approved as medication for OUD.[9]  Patients are required to abstain from opioids for a minimum of 7-10 days before beginning treatment with naltrexone, and should not use any other opioids or illicit drugs, drink alcohol, or take sedatives, tranquilizers, or other drugs once treatment begins.[10]  Naltrexone is not a recommended option for anyone younger than 18 years old, or patients experiencing other health conditions.[11]

Regardless of which medication is provided, MOUD is most effective when combined with counseling and other services that provide patients with a whole-person approach and support their recovery.[12]

Common Misconceptions about MOUD

Because methadone and buprenorphine are opioids and able to produce euphoria in people who are not dependent on opioids, some detractors have incorrectly concluded that this form of treatment just substitutes one drug for another.  That misunderstanding has unfortunately hindered the adoption of these effective treatments.[13]  In the past, even some inpatient treatment programs that were otherwise evidence-based did not allow patients to use these medications, in favor of an “abstinence only” philosophy.[14]

Although it is possible for people who do not have an opioid use disorder to get high on buprenorphine  or methadone, these medications affect people who have developed an opioid tolerance differently, so that the medications do not produce a euphoric high but instead minimize withdrawal symptoms and cravings.[15]  This makes it possible for the patient to function normally, attend school or work, and participate in other forms of treatment or recovery support services to help them become free of their substance use disorder over time.[16]

Thus, MOUD, particularly when combined with counseling and behavioral therapies, is strongly endorsed by the American Medical Association, the Center for Disease Control and Prevention (CDC), and other healthcare experts.[17]

Questions about Insurance Coverage for Treatment

If you have insurance, you should contact your insurance company and ask for a list of recovery and treatment providers that are in your network.[18]

If you still need assistance navigating coverage for your treatment options, NJ Connect for Recovery  is an advocacy organization with insurance specialists to answer your questions about private insurance, Medicaid, and Medicare coverage. NJ Connect for Recovery can guide you as to questions to ask your insurance provider, your treatment provider, and your rights with respect to insurance. If you are uninsured or underinsured, NJ Connect for Recovery can connect you with state funded treatment programs.  It is a free, confidential service.[19]

You can also call ReachNJ.GOV at (844) 732-2465 with general questions about substance use disorder treatment coverage including private insurance, Medicaid, and Medicare coverage.

If you are uninsured or have Medicaid, you can contact your local outpatient community mental health center.[20]  You can click here to access this information, by county.[21]

Finding an Opioid Use Disorder (OUD) Treatment Program Near You

Residential and non-residential treatment facilities for OUD are located throughout the state. These facilities are licensed by the New Jersey Department of Human Services.

To locate substance use treatment in New Jersey, you can:

  • Search a directory of licensed agencies by county at https://njsams.rutgers.edu/TreatmentDirectory/License. Services are available for both adults and adolescents, and treatment options include withdrawal management, intensive outpatient, outpatient, short-term residential, long-term residential, partial care, halfway house, and medication assisted- treatment. The directory does not indicate what type of insurance, if any, is needed to enter the services, and you will have to inquire further with the provider.
  • Call 1 844 ReachNJ.GOV at (844) 732-2465 for immediate assistance and a referral to the appropriate providers. ReachNJ.GOV refers adults without insurance to IME Addictions Access Center, a central state resource run through Rutgers Behavioral Health that helps people find effective access to treatment for New Jersey residents who seek treatment for their substance use disorder.
  • Call the IME Addiction Access Center directly 24/7, 365 days a year, at (844) 276-2777, for referral to addiction treatment.[22]
  • Persons ages 19 and under can call Perform Care – Children’s System of Care, at 1-877-652-7624. Perform Care is available 24/7, 365 days a year, to provide minors with referrals to treatment for substance use disorder treatment, as well as other behavioral health services.  Typically, Children’s System of Care behavioral health outpatient providers are Medicaid-approved. There are also outpatient providers that accept private insurance through other resources in your community. If you have private insurance, please talk with your insurance carrier to find other providers in their network.
  • Call Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Helpline, also known as the Treatment Referral Routing Service, at (800) 662-HELP (4357) or TTY: (800) 487-4889.  It is a confidential, free, 24/7, 365-day-a-year, information service—in English and Spanish—for individuals and family members facing mental health and/or substance use disorders. The SAMHSA hotline provides referrals to local treatment facilities, support groups, and community-based organizations.  If you have no insurance or are underinsured, the hotline will refer you to your state office, which is responsible for state-funded treatment programs or to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating healthcare providers and facilities.  [23]
  • Visit SAMHSA’s online treatment locator or send your zip code via text message435748(HELP4U) to find help near you.  Read more about the HELP4U Text Messaging Service.

[1]              See American Medical Association. “Medications to Treat Opioid Use Disorder (MOUD).” (https://www.ama-assn.org/topics/medications-treat-opioid-use-disorder-moud)
[2]              See SAMHSA, “Medications for Substance Use Disorders.”  Apr. 25, 2023.  (https://www.samhsa.gov/medications-substance-use-disorders).
[3]              See id.
[4]              See id.
[5]              See   National Institute on Drug Abuse, NIDA, “What are Misconceptions about Maintenance Treatment?” Dec. 2021 (https://nida.nih.gov/publications/research-reports/medications-to-treat-opioid-addiction/what-are-misconceptions-about-maintenance-treatment).
[6]              OTPs are structured and licensed outpatient programs that dispense and/or administer methadone in conjunction with appropriate counseling and other treatment services to patients with OUD.  AN OTP may also dispense and/or prescribe other treatment medication approved by the FDA for use in the treatment of OUD such as buprenorphine or naltrexone.  See https://njsams.rutgers.edu/TreatmentDirectory/License.
[7]              See SAMHSA, “Buprenorphine.” Jul. 18, 2023. (https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions/buprenorphine).
[8]              See SAMHSA, “Waiver Elimination (MAT Act).” Jun. 7, 2023. (https://www.samhsa.gov/medications-substance-use-disorders/waiver-elimination-mat-act).  See, e.g., NJ Division of Consumer Affairs, Pharmacy Board, “ALERT Removal of DATA-Waiver (‘X’ Waiver Requirement)” Apr. 2023. (“All prescriptions for buprenorphine only require a standard DEA registration number.  The previously used DATA-Waiver registration numbers are no longer needed for any prescription.”).
[9]              See SAMHSA, “Naltrexone.” Jun. 9, 2023. (https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions/naltrexone).
[10]             See id.
[11]             See id.
[12]             See SAMHSA, “Medications, Counseling, and Related Conditions.”  Mar. 22, 2023. (https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions).
[13]             See  NIDA, supra, “What are Misconceptions about Maintenance Treatment?”
[14]             See id.
[15]             See id.
[16]             See id.
[17]             See, e.g., B. Madras, Ph.D., et al. “Improving Access to Evidence-Based Medical Treatment for Opioid Use Disorder:  Strategies to Address Key Barriers within the Treatment System.”  NAM Perspect. 2020 Apr. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8916813/); Pew Research Center, “Medication-Assisted Treatment Improves Outcomes for Patients with Opioid Use Disorder.” Nov. 22, 2016 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8916813/).
[18]             See NJ Division of Mental Health and Addiction Services (DMHAS), “Frequently Asked Questions.” (https://www.nj.gov/humanservices/dmhas/home/faq/).
[19]             Mental Health Associates of NJ, NJ Connection for Recovery, “Insurance Questions?  Are you Covered?” (https://www.mhanj.org/insurance-questions/); https://www.njconnectforrecovery.org/insurance-questions/.
[20]             See DMHAS, supra note 18.
[21]             See id.
[22]             See Rutgers University Behavioral Health Care, “Interim Managing Entity (IME).” (https://ubhc.rutgers.edu/clinical/call-center/interim-managing-entity-ime.xml#:~:text=An%20individual%20who%20calls%20the,seeking%20treatment%20for%20a%20SUD).
[23]         See SAMHSA, “SAMHSA’S National Hotline.”  (https://www.samhsa.gov/find-help/national-helpline).

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