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 Phase 3 1x week group session 3x week group session 1x month individual session 2x month individual sessions 1x week UA (random) 1x week UA (Random) 1x week Rx pick up 1x week Rx Pick up (Daily for 30 days) Phase 4 1x month group session Phase 1 1x month individual session 2x week group session 2x month UA (random) 2x a month individual sessions 2x month Rx pick up 1x week UA (random) 1x week Rx pick up (Daily for 30 days) Monthly Monitoring 1x month group Phase 2 1x month Rx Pick up 1x week group session 1x month individual session 2x a month individual sessions Random UA’s 1x week UA (random) 1x week Rx pick up 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 2 nd vivitrol injection clients will be issued a $40 gift • card Upon receiving a 3 rd 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 Percentage of Compliance Pre/Post CM Program 94% 100% 90% 80% 70% 60% 50% 40% 31% 30% 20% 10% 0% May 2015 July 2017
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
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