In response to Mr. Tierney's Letter to the Editor regarding my article "The Advantages and Disadvantages of Medication-Assisted Treatment in Primary Care Offices," I want to thank Mr. Tierney for his letter, his work with substance abuse, and the opportunity to continue to promote medication assisted treatment (MAT).

Continuity of care is an important component of MAT. One of the disadvantages that could befall patients undergoing treatment is the potential lack of continuity within isolated primary care offices. This should not dissuade providers from partaking in this evidence-based practice but should encourage them to understand this potential loss of continuity. Understanding this disadvantage raises the need to implement improved provider handoffs and/or follow-up communication protocols. Mr. Tierney kindly objected the statement that requires counseling be provided for people receiving MAT. His acknowledgment of the federal DATA 2000 law that states providers "must attest that they have the capacity to refer addiction treatment patients for appropriate counseling" (SAMHSA, 2020a) is proof that counseling is required. In addition, SAMHSA defines MAT as "the use of FDA-approved medications, in combination with counseling and behavioral therapies, to provide a 'whole-patient' approach to the treatment of substance use disorders" (SAMHSA, 2020b). This is not to dissuade practitioners from utilizing MAT but brings recognition for potential lack of continuity and being cognizant to prevent dropout.

Most assuredly, this article was intended to promote the benefits of MAT in primary care offices for the many reasons discussed in the original article; however, I could not ignore the possible disadvantages and methods to overcome them.

Tonja Marie Padgett, DNP, RN, ACNS-BC, CNE

REFERENCES