Treatment Options

It is believed that 80% of individuals with Opioid Use Disorder do not receive treatment, but medical care for those struggling with OUD can be their best chance at living life without opioids.

There is a range of treatment options for those who struggle with OUD. With the right care, support, and treatment, recovery is possible — there is life with OUD. If you or someone you love is considering treatment, there are many paths to recovery including medication, inpatient treatment, 12 step programs, counseling, and more. For each person, there is an option that can work. There is hope.

Finding the right treatment path may take time. But you are worth it — recovery is possible for everyone struggling from Opioid Use Disorder. Learn more about the different options and paths available for you or your loved one’s recovery journey.

Medication

Medication Assisted Treatment, or MAT, uses approved medications to treat opioid use disorder. There are three main medication treatment paths. Though each medication works differently, MAT works in the brain to stop cravings and manage pain and withdrawal symptoms. MAT has been proven to be effective in many ways to:

  • Improve the chance for survival
  • Keep individuals in treatment
  • Lower opioid use and criminal justice involvement
  • Enable individuals to gain employment
  • Improve birth results for pregnant women who are addicted
  • Reduce the risk of getting HIV or Hepatitis C
  • Reduces the risk of relapsing
Naloxone
  • How it works: Naloxone binds to opioid receptors in the brain in place of opioid drugs. When opioids are prevented from binding to these receptors, the brain does not flood with dopamine due to the intoxicating substance. Although naloxone can have some side effects, it does not induce any euphoria when bound to opioid receptors in the brain, nor does it kill pain. It simply prevents opioids from binding there, which can temporarily reverse an overdose. The effects of naloxone begin within 2-5 minutes after the medication is administered.
  • Brand Names: Naxolone (injectable), Narcan (nasal spray), EVZIO (auto injectable)
  • The Naloxone + Opioid Response App (NORA) is a free interactive educational tool that will expand the understanding of what naloxone is and reinforce initial training given when a person fills their prescription for it. You can access the app at www.norasaves.com.

Methadone (Pronounced METH-uh-dohn)
  • How it works: Methadone is classified as a medical opioid and tricks the brain into thinking it is still receiving the desired opioid, usually heroin. The individual does not get high from using this medication when used correctly, but will avoid withdrawal symptoms. While methadone may produce mild euphoria, it blocks the other effects of opioids like heroin and pills. It is important to work with your doctor to use methadone correctly, as it can be harmful if misused.
  • Brand Names: Methadose, Dolophine, Methadone Diskets, Methadose Sugar-Free – available in pill, liquid, or water forms.
  • Treatment:
    • A medical professional will administer methadone in a specialized opioid treatment program (OTP) after you have been assessed by a doctor.
    • Methadone is most successful when combined with counseling and attending support groups.
    • Methadone is approved for those who are pregnant or breastfeeding.
    • People take methadone for as long as they need to stay off other more dangerous opioids.
Buprenorphine (Pronounced BUE-pre-NOR-feen)
  • How it works: buprenorphine reduces withdrawal symptoms and cravings. Buprenorphine has less effect on the respiratory system and does not produce euphoric feelings like other opioids. Buprenorphine is often combined with naloxone, increasing safety in case of an overdose. The prescriber has to have special training to prescribe this medication.
  • Brand Names: buprenorphine and naloxone can have the brand names Bunavail, Suboxone, or Zubsolv.
  • Treatment: buprenorphine treatment happens in three phases:
    • Induction: The first dose of buprenorphine can be given in a doctor’s office after the patient has not used opioids for approximately 4-6 hours and is experiencing withrawal symptoms. This is important because buprenorphine can cause someone to go into withdrawal if they aren’t already. Medical monitoring ensures there are no significant side effects. Home induction is also possible, if a person has taken buprenorphine in the past. Dose is adjusted as needed.
    • Stabilization: Begins after a patient has stopped use of their problem drug. Once cravings stop, the dose is adjusted.
    • Maintenance: When a patient is doing well on a steady dose of buprenorphine, they may remain in this phase as long as needed.
    • Buprenorphine is most successful when combined with counseling and attending support groups.
    • This medication is also safe for pregnant women.
Naltrexone (Pronounced nal-TREK-sohn)
  • How it works: Naltrexone works by attaching to opioid receptors, blocking the effects of opioids and alcohol. If a person relapses and uses an opioid or alcohol, naltrexone prevents the feeling of getting high. Naltrexone is not commonly misused since it causes no effects, but must be taken daily to prevent cravings from returning.
  • Brand Names: Brand Names for naltrexone include Vivitrol (injectable), ReVia, and Depade.
  • Treatment:
    • Individuals should stop using opioids for 4-7 days before starting naltrexone depending on a physician’s recommendation.
    • The injectable form is administered once a month and the pill is taken once a day.
  • Naltrexone is most successful when combined with counseling and attending support groups.
  • Naltrexone can be prescribed by any medical professional licensed to prescribe medications.
Types of Treatment Programs
Detox

Though this method is typically not necessary for opioid addiction, detox, or detoxification, is medically supervised withdrawal management that will improve a patient’s health and facilitate their participation in a rehabilitation program. This treatment will help individuals consider long-term treatment for a life without opioids, because they can think more clearly once difficult withdrawal symptoms have passed.

In medically supervised withdrawal, a physician provides medication to reduce the severity of withdrawal symptoms and continuously monitors the patient to ensure their safety and comfort throughout all stages of acute withdrawal. Medications for OUD can be started in a detox program.

Detoxing, without help from medication, can range from an uncomfortable process like a bad case of the flu, to a very painful physical experience. However, withdrawal is usually not life-threatening. It is smart to check with a doctor or counselor before quitting the use of opioids on your own if you are a heavy or long-term user.

For more information on bed availability for detox programs in Connecticut, visit http://www.ctaddictionservices.com/.

Inpatient/Residential

Some individuals benefit the most by changing their behavior in a structured residential setting. A residential treatment center is a setting where you live for a period time and recover with support available to you around the clock. Residential treatment promotes recovery in a place that is supportive, away from any temptation to use, and typically provides counseling and Substance Use Disorder (SUD) education.

This care can be short-term (3-4 weeks) or long-term (3-12 months) and may be provided in a variety of residential settings: substance use disorder facilities, and substance use disorder units within hospitals.

Recovery houses also provide a supportive, sober environment but do not offer on-site treatment. Residents of recovery houses generally stay 1-3 months and receive their outpatient treatment elsewhere.

For more information on bed availability for residential treatment, including Recovery Houses in Connecticut, visit http://www.ctaddictionservices.com/

Individual Counseling, Group Counseling, and Peer Support Programs

There are many pathways to recovery. Counseling and therapy use proven techniques to give people receiving treatment for substance use disorder tools to reduce or stop substance misuse and follow their recovery plan. Step recovery programs, individual counseling, and group counseling all play a different role, and can be used together for a holistic approach to recovery.

Individual Counseling and Therapy:

Some people may be misusing drugs to help ease symptoms associated with a physical condition or emotional struggle that contributes to their substance use disorder. Counselors are professionals who are trained to help you identify the factors that lead to addiction, and provide techniques to change negative thought patterns and behaviors. These professionals work one-on-one with the individual to develop tools and skills to achieve treatment and recovery goals; typically with an emphasis on a “higher power” and “sponsor” support.

Group Therapy:

People struggling with addiction can benefit from a counselor’s expertise in a group setting as well. One or more trained professional therapists work with individuals in a group setting. Support groups can be low-cost, help develop and practice sobriety skills, and provide support through treatment and recovery. Therapy in a group setting also provides some unique benefits such as the opportunity to give and receive support from peers, practice communication skills, and increase self-awareness.

Step Recovery Programs:

These programs are a great option for individuals who are ready to stop using drugs and are open to group meetings. The 12 step model’s supportive approach helps recovering individuals work toward their recovery goals.

Where to Get Treatment

There are many treatment and recovery centers throughout the state to help individuals with OUD or other addictions get help. To get more information about treatment options, call the Department of Mental Health & Addiction Services’ Access Line at 1 (800) 563-4086.

Or, locate treatment and recovery options by visiting:
https://public.tableau.com/views/CTBHPMedicaidMATProviderMap/TreatmentProviders/
https://www.ctaddictionservices.com/

How to Pay
Get Covered

The cost of rehabilitation, detox, and MAT can vary based on the level of care needed. There are a range of options to pay for treatment—including self-pay, private insurance or state insurance coverage, or financing through the rehab center.

Connecticut has many insurers who offer individual and group health insurance plans. It is important to know who your provider is; if you are not insured, it is recommended that you get coverage in case of a health emergency. For a list of available health insurance companies in Connecticut, visit the Connecticut Office of the Health Care Advocate’s website: https://www.ct.gov/oha.

I don’t have insurance

If you don’t have insurance, the state offers affordable health care options for you or your loved one to consider.

HUSKY: This state insurance program includes federal Medicaid and offers a program for adults. “Husky D” provides insurance for low-income adults without children and covers a range of behavioral health services. There are programs offered for families, those with disabilities, and those with children as well. For more information or to see if you qualify, visit the HUSKY website.

To apply for HUSKY healthcare, visit Access Health CT and apply online, dial 1 (855) 805-4325 to apply over the phone, or visit your local DSS field office to apply in person.

If you don’t qualify for HUSKY, there are alternative plans available to you. You can purchase an individual healthcare plan through Access Health CT.

I have State insurance

If you have insurance, it is important to know what your plan covers in case you need addiction treatment services. HUSKY provides comprehensive coverage which includes Behavioral Health Services. Behavioral Health Services include coverage of, but not limited to:

  • Detoxification
  • Residential rehabilitation (HUSKY D only)
  • Partial Hospitalization
  • Day Treatment
  • Outpatient Services
  • Prescription Coverage (through the CT Medical Assistance Program – CMAP)
  • Methadone Clinics and related lab fees for testing
  • All outpatient substance use clinic services (diagnosis doesn’t matter), including medications

To find out what other services are covered under your HUSKY plan, dial 1 (855) 805-4325 or visit Access Health CT.

I have Individual or Group Insurance

If you have a private insurance plan such as Aetna, Cigna, Anthem, Connecticare, or others, you may want to talk to your employer or call your provider to see what services are covered under your plan. The Mental Health Parity and Addiction Equity Act of 2008 requires insurance companies to make mental health benefits comparable to general medical coverage (this ensures that copays, treatment limitations, out-of-pocket expenses, etc. are all treated similar to other physical conditions). As of 2017, Connecticut passed a law requiring insurers to cover medically necessary inpatient detox services.

It would be helpful for you or your loved one to call your insurance company to determine your coverage. If you are unsure what questions to ask, see Suggested Questions to Ask below.

What’s Covered?

Coverage depends on your health insurance plan and its offerings. However, Connecticut law mandates that all individual and group policies provide benefits for the diagnosis and treatment of substance use disorders. The Connecticut Insurance Department works to ensure that insurance policies in the state cover necessary services to help with an addiction.

The state mandates the following services:

  • Residential Treatment
  • Chemical Maintenance Treatment/MAT

The state considers the following as “essential health benefits” in any plan:

  • Office Visits
  • Acute Inpatient Services
  • Partial Hospitalization
  • Intensive/Routine Outpatient
  • Substance Abuse Detoxification
  • Emergency Room & Urgent Care

When surveyed by the CT Insurance Department, most insurance providers covered all of the above. Each plan’s coverage may vary, so it is important for you or your loved one to get in touch with your insurance provider to learn about what benefits you have, how long you will have them, and if you are responsible for any additional costs.

Suggested Questions to Ask

To determine what kind of insurance you have and to learn more about your treatment options, you should call the Member Services department of your insurance company. Be sure to have your insurance card and member ID number handy. It would also be helpful to have a pen and paper nearby to take some notes.

  • What type of plan do I have? (i.e. EPO, HMO, POS, PPO, etc.)
  • What levels of care are covered? Inpatient services? Outpatient services? Medication Assisted Treatment/Chemical Maintenance Treatment?
  • If so, what is my deductible cost? What is the cost of each copay?
  • If I desire inpatient treatment, is there a limit for my stay? If so, how many days?
  • Will my coverage vary based on my stage of treatment? (Detox vs. continuing care)
  • Can you provide me with a list of in-network providers? (providers covered by the insurance plan)
  • Do I need to be pre-approved or be referred by a doctor to get coverage for treatment?
  • Ask them to send you a document that lays out what determines “medical necessity”
Office of the Healthcare Advocate

Health insurance can be a bit difficult to understand sometimes. Thankfully, the Connecticut Office of the Healthcare Advocate is available to answer your questions about your insurance plan and advocate for you to ensure you get the treatment you need! To contact the OHA, visit their website or call 1 (866) 466-4446.