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Medication-Assisted Therapy

Medication-Assisted Therapy. Vivitrol. Division of Addiction Services Vivitrol Pilot. Overall DAS has a goal to develop a system of care that consistently offers clients the means to enter and sustain recovery

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Medication-Assisted Therapy

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  1. Medication-Assisted Therapy Vivitrol

  2. Division of Addiction Services Vivitrol Pilot • Overall DAS has a goal to develop a system of care that consistently offers clients the means to enter and sustain recovery • To this end DAS hopes to promote evidence based practices in the treatment of addictions • One initiative in this area is the planned Vivitrol pilot

  3. Division of Addiction ServicesVivitrol Pilot • Objective: • Support and extend continuous abstinence • Afford client opportunity • stabilization during treatment • acquire skills necessary to independently support recovery • transition into Recovery Zone

  4. Medication Assisted TherapyWhat is Vivitrol? Vivitrol is injectable Naltrexone with the following benefits: • Works well with counseling • Reduces cravings • Decreased impulsivity • Enhanced motivation • Improved treatment adherence • Single injection is effective for four weeks - Eliminates daily adherence decisions • Rapid onset of therapeutic effect in the first 2 days • Generally well tolerated with a demonstrated safety profile

  5. Vivitrol • Injectable form of Naltrexone • Once monthly dosing • FDA approved 2006 • Manufactured by Alkermes, Inc. • An Evidence Based Practice - SAMHSA Treatment Improvement Protocol #49: “Incorporating Alcohol Pharmacology into Medical Practice”

  6. Journal of Substance Abuse TreatmentJanuary 2009 “The Effects of Extended-release Naltrexone on Holiday Drinking in Alcohol-dependent Patients” With Vivitrol: • Better able to avoid episodes of heavy drinking during the holidays • Opportunity to deal with the special dangers of alcohol-impaired driving

  7. Choosing the Pilot Cohort DUI Population • Higher rate of alcohol as primary drug of choice • Looking for evidence of a decrease in DUI offenses (clients don’t go on to offend again) • Supported with DUII funding

  8. Choosing the Pilot Cohort Of clients with primary alcohol diagnosis admitted in NJSAMS: 3,700 admitted to detoxification 985- at least one DUI offense 423- more than one episode of detoxification 288- both multiple detoxification and multiple DUI offenses

  9. DAS IDP Vivitrol Pilot • Goals for DUI offender participants: • Period of stabilization in which to embark upon recovery • Reduction or elimination of DUI offenses • Decrease of additional detoxification episodes

  10. DAS IDP Vivitrol Pilot • 100 voluntary participants • DUI multiple offender • Alcohol Dependent Diagnosis • DUII eligible • Present and admitted for alcohol detoxification

  11. Supplemental Services Available to Pilot Participants • Physician and Patient Education • Up to six injections per client while in treatment • Medical visits

  12. DAS IDP Vivitrol Pilot How It Works • DUII Network of Vivitrol Providers as a subset of DUII Network who will be trained and eligible for reimbursement for pilot services • Clients receive initial injection at discharge from detoxification • Follow up injections and continuing care treatment at a DUII/ Vivitrol Provider Agency • DUII will reimburse for the medication and all services

  13. Study the Impact • Pursuing offer from CSAT to assist with outcome study • Study will assess • Client outcomes • Costs

  14. Questions/Feedback

  15. Who to Contact? Vicki Fresolone Director of Treatment Services Vicki.Fresolone@dhs.state.nj.us Ann Wanamaker Assistant Chief, Intoxicated Driving Program Ann.Wanamaker@dhs.state.nj.us Lisa Mojer-Torres, Consumer Advocate Lisa.Mojer-Torres@dhs.state.nj.us

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