Barriers to Mat in North Carolina

Medication-assisted therapy treats substance use disorder through a combination of counseling and medications.

While it can be very effective, there are barriers to MAT in North Carolina that may prevent many people from receiving treatment.


MAT is very expensive, which may prevent people from seeking and receiving treatment. According to North Carolina Health News, the Department of Health and Human Services has provided funds to help defray the cost for some people. However, an estimated one out of every 20 people in North Carolina has a substance use disorder, and the funds have only gone to treat 10,000 to 12,000 people.

Need for detox

One of the medications used in MAT, naltrexone, can cause serious side effects if there is any residue of opioids in the system. Patients need to be completely clean for seven to 10 days before the treatment can begin. This requires them to go through the difficult process of detoxification first.


Other medications used in MAT include methadone and buprenorphine. The controls on these medications are so strict that doctors have to apply for a waiver to prescribe them to treat substance use disorder. They can only receive the waiver if they complete an eight-hour training program. Only 7% of doctors in the United States have received the necessary training to prescribe medications for MAT.

The irony is that the controls regulating medications to treat substance use disorder are stronger than those on opioid medications. Many of the people who become addicted to opioids started taking them because of a doctor’s prescription for a legitimate medical complaint.

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