Medicated Assisted Treatment Carol VanConett, CDP Aaron Soto CDP, - - PowerPoint PPT Presentation

MUCKLESHOOT BEHAVIORAL HEALTH

Medicated Assisted Treatment

Carol VanConett, CDP Aaron Soto CDP, MHA Lana, Misty & Ben 15 OCT 2018

Overview

• Currently 250 clients receiving Chemical

Dependency Services

115 are in Medication Assisted Treatment (MAT)

• Medication-Assisted Treatment is the use of

medication in combination with counseling services. This is considered the gold standard of treating Opioid Use Disorder. The medications we use are Suboxone and Vivitrol.

BHP Suboxone Program

An Example of Integrated Services

• 8 CDPs (3 CDPs for Suboxone Clients)
• 2 MDs prescribing Suboxone
• 2 Outreach Advocates
• 2 Pharmacy staff -daily, weekly and monthly

dispensing for Suboxone

• 1 medical Social Worker

BHP Suboxone Program

Process:

• CD assessment

– Referral to MAT (Suboxone or Vivitrol) – Average 2-6 days for a client to get appointment for Suboxone induction – Level of Care assessed (Medical Detox or Inpatient*)

BHP Suboxone Program

Process cont…

• Weekly CD staff meeting within BHP
• Weekly multidisciplinary meeting (CDPs,

Pharmacy, Medical Provider and Medical Social Worker, Dental*).

• Medical Social Worker works specifically

with our pregnant clients.

Suboxone Treatment Phases

Suboxone IOP 3x week group session 2x month individual sessions 1x week UA (Random) 1x week Rx Pick up (Daily for 30 days) Phase 1 2x week group session 2x a month individual sessions 1x week UA (random) 1x week Rx pick up (Daily for 30 days) Phase 2 1x week group session 2x a month individual sessions 1x week UA (random) 1x week Rx pick up Phase 3 1x week group session 1x month individual session 1x week UA (random) 1x week Rx pick up Phase 4 1x month group session 1x month individual session 2x month UA (random) 2x month Rx pick up Monthly Monitoring 1x month group 1x month Rx Pick up 1x month individual session Random UA’s Medical Monitoring (after graduation from BHP) 2 sober support meetings every week**

BHP Vivitrol Program

Vivitrol Statistics

Year Client Served Total # on Injections 2012 51 120 2013 69 186 2014 99 334 2015 103 331 2016 101 358 2017 110 344 2018 (thru Sept) 71 222

MIT’s Vivitrol Contingency Management Program

• The use of a reward (Gift Cards) for compliant with treatment

expectations

• We consulted with Dr. Richard Ries, national expert in

Addiction Psychiatry from the UW, to determine effective protocol

In order to receive rewards (gift cards), clients must:

• Attend all required groups and individual sessions
• Negative random UAs for alcohol or any non-

prescription medications

• Attend a minimum of 2 self-help meetings per week

MIT’s Vivitrol Contingency Management Program

If client is in compliance with requirements:

• Upon receiving a 2nd vivitrol injection clients will be issued a $40 gift

card

• Upon receiving a 3rd and any further injections, client will be issued

an $80 gift card

• The clients really like this reward system. It’s worth every cent

MIT’s Vivitrol Contingency Management Program

31% 94% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% May 2015 July 2017

Percentage of Compliance Pre/Post CM Program

NARCAN Distribution

We have distributed over 4,000 NARCAN Kits since January 2014.

• Distribution of NARCAN kits:

Homes on the Reservation, front desk of BHP, Pharmacy, Community Events (Pow Wows, Dinners, Needle Exchange)

• Community educational presentation on overdose

awareness and protocols on NARCAN use.

• More than 40 reversals reported, and many others

unreported

Needle Exchange Program

Start date: February of 2016.

• In 2016 we served a total of 433

(duplicated) Tribal/Community Members and exchanged a total of 11,718 needles.

• In 2017: Served 721 exchanged a total of

33,581 needles.

• Through March 2018: 196 exchanging 10,610

needles

Thank you

Questions?

Please feel free to contact us at:

Muckleshoot Behavioral Health Program. Phone: (253) 804-8752

• Aaron.soto@muckleshoot-health.com
• Carol.Vanconett@muckleshoot-health.com