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)”.
- The MAT Enrollment Process
- 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!)
- MAT enrollment isn’t the fastest process, though patients can expect same-day acceptance. MAT enrollment is long, drawn-out, and takes anywhere from 90 minutes to 3 hours. Most applicants get accepted by their respective MAT programs and are allowed to choose which MOUD they want — methadone, buprenorphine, or naltrexone. However, not all providers offer each MOUD.
- There are two types of MAT providers: Opioid Treatment Programs (a.k.a. methadone clinics; can prescribe all three MOUD) and Office-Based Practitioners (can only prescribe buprenorphine and naltrexone).
- SAMHSA has two MAT provider lookup tools: the Opioid Treatment Program Directory (for OTPs), which lists all OTPs in the country; and the Buprenorphine Practitioner Locator (for Office-Based Practitioners), which lists almost all Office-Based Practitioners in the U.S. While these resources are quite extensive, most of these providers aren’t free.
- The State of Tennessee has two MAT provider lookup tools: a map of all Opioid Treatment Programs (methadone clinics) and a directory of all Office-Based Practitioners (Suboxone® clinics). While these resources are comprehensive, most of these providers aren’t free.
- The State of Tennessee maintains an up-to-date list of all SAPT Block Grant-funded addiction treatment providers. Treatment at these providers is 100% free, if you qualify. Currently, 39 of Tennessee’s SABG-funded providers offer MAT — 33 offer buprenorphine, 9 offer methadone, and 27 offer naltrexone. This is a slight decrease from the 2021-2022 fiscal year.
- Tennessee has a hub-and-spoke network of MAT providers. The hub-and-spoke model is a new model for delivering addiction treatment services that was first used in Vermont in 2013. Treatment costs at Tennessee’s 36 hub-and-spoke providers ranges between free and $20/week, if you qualify.
The MAT Enrollment Process
Find provider. Call provider, set up appointment. Go to appointment. Pay provider. Fill out paperwork. Go through intake, which includes:
- Physical exam
- Personal and family health history
- Personal and family drug use history
- Determination of current opioid dependence and length of addiction
- Drug screen
- TB (tuberculosis) skin test
- Blood draw to check for blood-borne diseases
Sign a bunch of documents. Talk to counselor. Talk to doctor. Doctor decides whether you need medication-assisted therapy. If accepted, you’ll be dosed on-location or given a prescription. You will almost certainly be accepted.
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 Lookup Tools
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:
|Program Name||Street||City||State||Zip Code||Phone||…|
|CRC Health of Tennessee||999 Girl Scout Rd||Burns||TN||37029||(615) 446-7034||…|
|Volunteer Treatment Center, LLC||2347 Rossville Blvd.||Chattanooga||TN||37408||(423) 265-3122||…|
(several columns cut off due to formatting issues)
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.
Results for each practitioner includes the following information:
|First Name||Last Name||Sub Type||Address||City||State||Zip Code||Telephone|
|Jennifer||Junghen||NP||N2950 State Road 67||Lake Geneva||WI||53147||262-245-0535|
|Matthew||Beeson||MD/DO||1100 Bergslien Street||Baldwin||WI||54002||715-684-1111|
* Some practitioners don’t consent to releasing their practice information to the public; so, while this might not be a complete list, it’s still the most comprehensive directory of office-based MAT practitioners known to man.
How Much Does It Cost? — SAMHSA’s Lookup Tools
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 Chapter 5 and Chapter 6, 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 5 and Chapter 6.
Tennessee’s SAPT Block Grant Providers (free!)
Note: Full list of SAPT Block Grant providers here! Updated July 1, 2022.
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.
Currently, 39 addiction treatment providers across the Volunteer State receive SABG funding to cover MAT costs, down from 41 providers in FY 2021-2022. Find the full list for yourself here (new FY 2022-2023 list, effective July 1, 2022).
We calculated the prevalence of each type of MOUD among Tennessee’s SABG-funded MAT providers:
|Region||B only||M only||N only||B+M||B+N||M+N||B+M+N||TOTAL|
|Middle||2||0||1||1 (–1)||10||0||0||14 (–1)|
|East||1 (–1)||1||4||4||7||0||0||17 (–1)|
|TOTAL||3 (–1)||1||5||8 (–1)||22||0||0||41 (–2)|
Here’s another way to look at it — out of Tennessee’s 41 SABG-funded MAT providers:
- Buprenorphine: 33 of 41 (decrease of 2 from FY 2021-2022)
- Methadone: 9 of 41 (decrease of 1 from FY 2021-2022)
- Naltrexone: 27 of 41 (same number as FY 2021-2022)
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|
|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? — SABG Providers
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 SOR/Hub-and-Spoke Network (free!)
Note: Full list of SOR Grant providers here! Updated July 1, 2022.
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
There are currently 4 hubs and 32 spokes across Tennessee that receive SOR funding to cover MAT costs, down from 4 hubs and 33 spokes in FY 2021-2022. Find the full list for yourself here (new FY 2022-2023 list, effective July 1, 2022).
Each of the four hubs kinda 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 (#28 Pathways, #29 BHG Jackson) in my county of residence (Madison) even though this isn’t a system-wide rule.
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? — SOR/Hub-and-Spoke, Providers
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!)