This is Part 2 in our MAT series. If you’re not already familiar with MAT, go back and read Part 1, “Introduction to Medication-Assisted Treatment (MAT)”.
- Types of MAT Providers
- SAMHSA’s Lookup Tools
- Tennessee’s Lookup Tools
- Tennessee’s SAPT Block Grant Providers (Free!)
- Tennessee’s SOR/Hub-and-Spoke Network (Free or almost-free!)
Summary
- There are two types of MAT providers: Opioid Treatment Programs (OTP) and Office-Based Practitioners (OBOT).
- SAMHSA has two MAT provider lookup tools: the OTP Directory and the Buprenorphine Practitioner Locator.
- The State of Tennessee has two MAT provider lookup tools: a map of all OTPs (methadone clinics) and a directory of all OBOT providers (Suboxone® clinics).
- Tennessee has 40 MAT providers that offer grant-subsidized MAT treatment.
- Tennessee has a hub-and-spoke network of MAT providers.
Types of MAT providers
Federal regulations allow for two types of medication-assisted treatment programs: Opioid Treatment Programs and Office-Based Practitioners.
Opioid Treatment Programs (OTP) (a.k.a. methadone clinics) are highly regulated medical facilities that use medication-assisted treatment to treat opioid use disorder. The defining characteristic of an OTP is that it dispenses methadone (though it may also prescribe buprenorphine and naltrexone).
Office-Based Practitioners (OBOT) (a.ka. Suboxone® clinics) are individuals — typically physicians, though also advanced practice nurses and physician assistants — who prescribe buprenorphine or naltrexone to treat opioid use disorder.
SAMHSA’s Opioid Treatment Program directory
This tool generates lists of OTPs in all 50 states, five U.S. territories, and the Federated States of Micronesia (for our purposes, it’s pretty much a territory). Simply select your state from the dropdown menu and it’ll generate a list of in-state OTPs — it’s that simple.
The results for each state or territory are populated in a list like this:
SAMHSA’s Buprenorphine Practitioner Locator
This tool lists most office-based medication-assisted treatment programs throughout the U.S., listing them by state, city, or zip code — your choice. Although some practitioners don’t consent to releasing their practice’s information to the public, this resource is still the most comprehensive directory of OBOT providers in the U.S.
How much does it cost?
Unlike the other two categories listed below — SAPT Block Grant (SABG) and SOR/hub-and-spoke providers — the providers listed on these two lookup tools might not offer any kind of financial assistance. In my experience, monthly cash-pay MAT costs can range up to $875/month.
Many of the medication-assisted therapy providers you’ll find take insurance. However, many of us don’t have insurance. If you’re interested in finding grant-funded (a.k.a. FREE!) MAT providers, look below!
Tennessee’s lookup tools
The State of Tennessee offers a few lookup tools to help people find MAT programs.
Here is a map of the 22 Opioid Treatment Programs — better known as methadone clinics — in Tennessee.
Here is a directory of all providers with a Tennessee Department of Mental Health and Substance Abuse Services license. To get the list of every office-based practitioner — better known as Suboxone® clinics — in the state, select “Alcohol and Drug Non-Residential Office-Based Opiate Treatment Facilities”.
Unlike the information in Section 4 and Section 5, the providers you find with Tennessee’s lookup tools — the map and the directory mentioned above — aren’t guaranteed to offer free service. In fact, most of them don’t offer free service. If you’re looking for free service, skip directly to Chapter 4 and Chapter 5.
Tennessee’s SAPT Block Grant providers (free!)
Note: Full list of SAPT Block Grant providers here!
Started in 1992, the Substance Abuse Prevention and Treatment Block Grant (SABG) is one of the largest sources of funding for — you guessed it — services that prevent and treat substance use disorder.
As of June 2023, 40 addiction treatment providers across the Volunteer State receive SABG funding to cover MAT costs, down from 41 providers in FY 2021-2022.
Out of Tennessee’s 40 SABG-funded MAT providers:
- 34 offer buprenorphine
- 10 offer methadone
- 26 offer naltrexone
Eligibility criteria
To qualify, your income must not exceed 133% of the Federal Poverty Guideline. Determined by the U.S. Department of Health and Human Services, here’s how the 2022 Federal Poverty Guidelines break down:
| # of Residents in Household | Poverty Guideline |
|---|---|
| 1 | $13,590 |
| 2 | $18,310 |
| 3 | $23,030 |
| 4 | $27,750 |
| 5 | $32,470 |
| 6 | $37,190 |
| 7 | $41,910 |
| 8 | $46,630 |
| For every additional resident, add… | $4,720/resident |
Also, prospective enrollees receive priority for admission if they meet at least one of these conditions:
- Using drugs via injection (IV)
- Being pregnant and using drugs
- Being pregnant and injecting drugs
- Being in need of detox services
How much does it cost?
Any treatment offered by SABG providers is free to people who meet the income eligibility requirements above.
Note: SABG and SAPT Block Grant can be used interchangeably. If I were to refer to these providers IRL, I’d probably use the phrase “SAPT Block Grant.”
Tennessee’s Hub-and-Spoke Network
Note: Full list of SOR Grant providers here!
Hub-and-spoke is a relatively new model of delivering addiction treatment services. Hubs are comprehensive, big-time service providers that offer everything from once-a-month telehealth counseling visits to detox and intensive residential rehab; they also offer consultations and and training to spokes. Spokes do the legwork — these locations actually provide MAT recovery.
Tennessee’s hub-and-spoke network is funded by a federal State Opioid Response grant — that’s where the “SOR” comes from. You can pronounce it like sore or soar, or spell it out letter-by-letter (ess–oh–are).
There are four hub-and-spoke networks in Tennessee:
- Upper East
- East
- Middle
- West
There are at least 36 hub-and-spoke network members across the Volunteer State — 4 hubs and at least 32 spokes. Find the full list for yourself here (new FY 2022-2023 list, effective July 1, 2022).
Each of the four hubs kind of gets to set their own rules about how they handle patients. For example, I was told by my region’s hub that I was only allowed to choose from the two providers in my county of residence (Madison) even though this isn’t a system-wide rule.
Eligibility criteria
We will update this when we get our hands on a full list of the eligibility criteria, but the most important one is that you must be employed or actively seeking employment. All other criteria is pretty cut and dry: just follow your provider’s rules and you’ll be okay.
How much does it cost?
People who are covered by the SOR (pronounced two ways: “soar,” like an eagle, or spelled out letter-by-letter, like ess–oh–are) grant pay different amounts depending on the MOUD they choose:
- Buprenorphine: free
- Methadone: $20/week
- Naltrexone: free
Providers might not tell you about the SOR grant, so make sure to ask your provider if they participate in the SOR program.
Done with this page? Move on to Part 3, MOUD Explained — Buprenorphine, Methadone, and Naltrexone (coming soon!)