Medications For Addiction Treatment

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Network Name

Clinic Branch

Address

Neighborhood

MAT Availability

Service Planning Area (SPA)

Medications Acamprosate tabs ( Campral ) Disulfiram ( Antabuse ) Naltrexone long acting injection ( Vivitrol ) (AUD) Naltrexone tabs ( Revia ) Buprenorphine long acting injection ( Sublocade ) Buprenporphine / Naloxone Sublingual ( Suboxone ) Naltrexone long acting injection ( Vivitrol ) (OUD)

Type of Visits In-Person Telehealth Telephone visits

Options for Un-Insured Patients Enrollment assistance Full cost ( cash pay ) No cost ( MyHealthLA ) Sliding fee scale

Contact Information #1 Name Title Phone # Phone Ext Email Address Additional Details

Contact Information #2 Name Title Phone # Phone Ext Email Address Additional Details

Can Get Buprenorphine Prescription at First Appointment?

Required to Change Primary Care Provider to this Clinic to Continue to Receive MAT?

Opioid Abstinence Expected to Receive Ongoing Buprenorphine Prescription?

Abstinence from Alcohol Required for Vivitrol?

Office Initiation of Buprenorphine

Urine Toxicology Samples Required?

Counseling/Therapy Required to Receive MAT?

Insurance/Payment

Other Support Services Offered

Additional Details/Requirements

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