Frequently Asked Questions
Medication-Assisted Treatment FAQs
What is medication-assisted treatment?
Medication-Assisted Treatment (MAT) is not a standalone treatment. It combines medications with behavioral therapy, psychosocial supports, and other wraparound services, leading to the best outcomes. MAT provides a “whole-patient” approach to treat addiction to opioids such as heroin or prescription pain relievers. MAT can also be used to support treatment for alcohol use disorders.
What types of addiction/disorder does it treat?
Opioid Use Disorder (OUD) - By helping normalize brain chemistry, blocking the euphoric effects of opioids, and relieving physical cravings, without the negative effects of the drug.
Alcohol Use Disorder - By blocking the euphoric effects of alcohol intoxication. The goal of the specific medication is to help individuals disassociate alcohol from pleasurable feelings and experiences. Ultimately, this interaction encourages the individual to maintain his/her commitment to recovery.
What medications are used for alcohol treatment?
Medications include Acamprosate, Naltrexone, Disulfiram, and Gabapentin
What medications are used for opioid treatment?
Options include Buprenorphine, Naloxone, and Naltrexone
How long does MAT treatment take?
MAT treatment is individualized for each client.
Does a person with the addiction just need to take the prescribed medication?
No - Medication is one tool in the recovery toolbox. Clients will receive behavioral therapies and psychosocial support.
Are you just replacing one drug with another?
No, non-prescription medications are replaced by prescribed and appropriately dosed FDA-approved medication.
Are these medications safe?
Yes, all medications are FDA approved and prescribed by trained and licensed providers.
Can I use insurance?
Most insurances do cover MAT.
What is the process to become a MAT client?
- Clients will complete a substance abuse intake with an assigned Substance Abuse Counselor.
- The Substance Abuse Counselor will establish a level of care and make a referral to a Medication Manager.
- The Medication Manager will assess the client and advise the client regarding treatment options, induction timing, precipitated withdrawal, and the role of therapy in treatment.
- The client will sign a treatment agreement and be willing to follow all treatment recommendations, all follow-up appointments are critical to the long-term success of recovery.
TMS Therapy FAQs
What is TMS?
TMS stands for transcranial magnetic stimulation. It is a non-surgical procedure used to treat depression by stimulating the brain using electromagnetic fields, similar to those produced by an MRI machine. During TMS Therapy, a magnetic field is administered in very short pulses to the part of the brain that is associated with depression. These pulses of magnetic energy are the same type and strength as those produced by an MRI.
TMS Therapy uses short pulses of electric current to stimulate the brain cells in the area of the brain that is thought to function abnormally in patients with depression. These electrical currents activate cells within the brain which are thought to release neurotransmitters like serotonin, norepinephrine, and dopamine. Since depression is thought to be the result of an imbalance of these chemicals in the brain, TMS can restore that balance and, thus, relieve depression.
Does TMS hurt?
The most commonly reported symptom is some sensitivity at the site where the magnetic pulse is directed. Many patients describe the feeling of TMS as a light tapping or ‘tingly’ sensation on their forehead.
The most common side effect of TMS is a temporary mild headache during or shortly after the TMS session. Most patients who experience headaches report that they only happen in the first week or two of treatment. Other symptoms include mild facial twitching during treatment or a slight tingling sensation on the forehead or scalp at the site of the stimulation.
Does it work?
For many people, depression symptoms significantly improved or went away after 4 to 6 weeks of treatment with NeuroStar Advanced Therapy.
In clinical trials after the acute phase of treatment, 33% of patients achieved remission, and 62% had a positive response (50% reduction in symptoms).
What are the side effects?
The most common side effect is discomfort at the treatment site. Some patients complain of a headache following treatments for the first few days. Your doctor may recommend taking an over-the-counter medicine before your treatment if you experience discomfort. Most patients find any discomfort lessens after the first 5 days of treatment.
You get to relax in a comfortable reclining chair. You will feel a tapping sensation on the front part of the left side of your head. Everyone perceives the pulses differently, and your provider can make adjustments so you are more comfortable.
Is TMS safe?
The FDA approved the use of TMS for the treatment of depression in 2008. Since then, multiple clinical trials have been done on tens-of-thousands of patients. The results of these studies have proven that TMS Therapy is a safe and effective alternative in treating patients who have not experienced adequate relief from their depression symptoms with medications.
Is TMS like shock therapy?
Yes and No. Although TMS and Electroconvulsive Therapy (aka ECT or ‘Shock Therapy’) both work to stimulate the brain; ECT must be administered in a hospital setting, and you must be sedated (put to sleep) in order to tolerate the treatment. In ECT, electric currents are delivered to the brain in way that causes small seizures. The most commonly reported side effects of ECT treatment are nausea, headache, jaw pain, muscle aches, confusion, or even memory loss of events that occurred in the weeks before or after treatment.
With TMS, the treatments are given in an outpatient/office setting, while you are awake. During TMS sessions, patients are encouraged to read, watch videos, play a game on their phone, or participate in any other activity that they can while sitting upright in the TMS chair. It is important to take in positive stimuli while the treatment is in progress.
Is TMS safe?
Do I stop taking my medications when I go through TMS Therapy?
Do not stop taking your medications prior to TMS Therapy. Throughout the course of your therapy, we will work with your Primary Care Physician or Health Care Provider to manage your medications. Some people continue to take some or all of their antidepressant medications throughout the entire course of treatment. Based on your response, your doctor may begin tapering off some of your medications during or after TMS therapy.
Why is TMS therapy better than medication?
For people with Major Depressive Disorder (MDD), long-term remission becomes less likely with each prescription medication treatment attempt. As antidepressant medication increases, so can side effects and the potential for treatment failure.
NeuroStar Advanced Therapy can help people who struggle with MDD even after taking antidepressant medication. It helps activate the natural function of the brain’s neurotransmitters using a non-invasive magnetic field.
How much does TMS cost and does insurance cover it?
Most health insurance companies cover TMS Therapy, but the amount of coverage for the treatment can vary for each insurance provider. Some will cover it 100%, while others will only cover a portion of the cost. The out-of-pocket cost for you may differ based on your plan benefits, co-pays, or deductibles. With your consent, we can do a benefit investigation prior to determine exactly what your out-of-pocket cost would be. We can also work with you on payment options as needed.
How long does a TMS course of therapy take?
The typical initial course of treatment consists of 30-36 sessions. One treatment session takes about 20-30 minutes. A standard TMS Therapy schedule is one session per day, 4 or 5 days a week for 6 weeks. After the initial phase, the therapy is tapered off over the course of 3 weeks with 2-3 sessions [days] per week. The total ‘treatment period’ is between 2-3 months, depending on how it is scheduled.
What if I can’t come every day or if I miss days?
For optimal results, we recommend following the standard treatment schedule, BUT we understand that things come up in life. If you have to miss an appointment, we will work with you to reschedule your session. If a major life event occurs, and you have to miss multiple sessions, we will provide counsel on your options for resuming therapy so that you can have the best possible outcome.
How long does it take for TMS to work?
The response to treatment varies based on the individual. Many patients start to feel the positive effects of TMS therapy after the first week, but on average, patients reported a “Noticeable Difference” in their general mood sometime between 2-4 weeks of therapy. Many patients reported that their depression symptoms continued to improve even after their course of therapy was complete.
How long do the effects of TMS last?
The lasting effect of TMS varies by patient; however, multiple clinical trials [studies] have shown that after one year nearly 70% of patients maintained their level of response (which means they felt the same way as they did after completing their course of treatment); and 45% of patients achieved ‘remission’ (meaning they found relief from or were free of depressive symptoms). In some cases (maybe due to age, life changes, severity of depression, or environmental factors), patients may need to return at some point for an additional course of TMS Therapy, called ‘maintenance therapy’. In clinical studies only 1 in 3 patients needed to return for maintenance therapy sessions.
Spravato® (Esketamine) FAQs
What are side effects of Spravato® (Esketamine) nasal spray?
Common side effects include sedation, dissociation, and increased blood pressure during treatment. A full list of potential side effects can be found at Spravato.com A trained professional will monitor you during and after treatment.
Additional Resources
For more information about Spravato®, visit www.Spravato.com.
How much does it cost and does insurance cover it?
Due to its innovative treatment and proven efficacy, Esketamine nasal spray may be covered by your insurance health plan. Many insurance companies have established medical coverage policies. The specialty pharmacy will determine eligibility.
As coverage and payment can vary based upon the patient’s specific plan and guidelines, it is best to contact your insurance company to verify eligibility, benefits, and coverage for Esketamine nasal spray.