Medication-Assisted Treatment (MAT)

Medication-assisted treatment (MAT), including opioid treatment programs (OTPs), combines behavioral therapy and medications to treat substance use disorders.

Notification: The SUPPORT for Patients and Communities Act of 2018 expanded the ability of certain physicians to treat up to 100 patients if they satisfy one of the following two conditions:

  1. The physician holds a board certification in addiction medicine or addiction psychiatry by the American Board of Preventive Medicine or the American Board of Psychiatry and Neurology; or
  2. The physician provides medication-assisted treatment (MAT) in a "qualified practice setting." A qualified practice setting is a practice setting that:
    1. provides professional coverage for patient medical emergencies during hours when the practitioner's practice is closed;
    2. provides access to case-management services for patients including referral and follow-up services for programs that provide, or financially support, the provision of services such as medical, behavioral, social, housing, employment, educational, or other related services;
    3. uses health information technology systems such as electronic health records;
    4. is registered for their State prescription drug monitoring program (PDMP) where operational and in accordance with Federal and State law; and
    5. accepts third-party payment for costs in providing health services, including written billing, credit, and collection policies and procedures, or Federal health benefits.

How do I begin to treat 100 patients?

Physicians who do not have board certification in Addiction Psychiatry or Addiction Medicine, but who provide MAT in a "qualified practice setting," must satisfy the 8 hours of required training (or otherwise qualify as a "qualifying physician" under 21 U.S.C. 823(g)(2)(G)(ii)), and complete the Notice of Intent (DATA waiver application) indicating that you will treat up to 100 patients with opioid use disorder. All physicians who intend to treat up to 100 patients by meeting at least one of the above criteria must file a Notice of Intent to treat 100 patients with SAMHSA prior to increasing the number of patients with opioid use disorder to whom they are providing FDA-approved medications on Schedules III, IV, or V.

If you are a physician who meets one of the above requirements and you currently possess a DATA waiver to treat 30 patients, you must file a Notice of Intent to treat 100 patients with SAMHSA in order to increase your patient limit. The passing of the SUPPORT Act removes the requirement for you to wait one year prior to doing this.

Medicated-Assisted Treatment (MAT) is the use of FDA-approved medications, in combination with counseling and behavioral therapies, to provide a "whole-patient" approach to the treatment of substance use disorders.

Find information on physical ailments often diagnosed in MAT patients. Also known as common comorbidities, these include viral hepatitis, HIV, and AIDS.

There are three medications commonly used to treat opioid addiction:

  • Methadone – clinic-based opioid agonist that does not block other narcotics while preventing withdrawal while taking it; daily liquid dispensed only in specialty regulated clinics
  • Naltrexone – office-based non-addictive opioid antagonist that blocks the effects of other narcotics; daily pill or monthly injection
  • Buprenorphine – office-based opioid agonist/ antagonist that blocks other narcotics while reducing withdrawal risk; daily dissolving tablet, cheek film, or 6-month implant under the skin

Check with your doctor on the right one for you.

MAT for opioid addiction is subject to federal legislation, regulations, and guidelines, including DATA 2000 and federal regulation 42 CFR 8.

SAMHSA's Dear Colleague Letters offer providers of MAT services guidance on emerging issues related to opioid treatment.

Access Model Guidelines for State Medical Boards.

Learn more about special circumstances for providing buprenorphine.

Last Updated: 04/26/2019