Catawba and iredell: medication assisted treatment program - mcleod addictive disease center is applying to implement the catawba/iredell medication assisted treatment program (CI-mat) in two…

Catawba and iredell: medication assisted treatment program - mcleod addictive disease center is applying to implement the catawba/iredell medication assisted treatment program (CI-mat) in two west/central north carolina counties with a population of ~354,000, targeting those with an OUD and the 50% with CO-occurring substance use disorders (SUD). We will focus on minority and unhoused consumers, with close to two-thirds also challenged by untreated trauma and BH challenges. Local managed care organization data finds that 2/3's of those with OUD have trauma histories of which only 20% are specifically treated for trauma. Those with untreated trauma were 4X as likely to leave treatment within 4-months and had 5-7X the number of positive drug screens during treatment compared to those without trauma history. 16% of the population has been prescribed opioid medications, much higher than the state average. Incarceration rates are at or above the state average and foster care due to OUD and related are 10-25% higher than the state average. This also indicates a younger population to be served. Behavioral health and additional challenges have severely limited retention in mat programs for which this program is designed to improve. We will serve a total of 333 consumers, ranging from 62-70 each year. Consumers will have the choice of an opioid treatment program (OTP,) or an office-based opioid treatment (obot), program. Consumers will receive appropriate medications per the provider type with emphasis on reducing diversion risk. Services will use a range of evidence-based practices (EBP) for treatment needs, recovery-based services for OUD and any CO-occurring SUD, a comprehensive screening and assessment process, with services specific to trauma and behavioral health issues when detected. Peer support services will be available to all consumers as well as linkage with local recovery-based organizations to support/maintain gains. We will have special emphasis on those unhoused and will have sober housing available at multiple locations. We will emphasize retention and sharing of consumers between the programs for the best fit for service. To support this, a low-threshold approach will be used if requested and appropriate. We will address four goals: 1) increase use and integration of medication assisted treatment and evidence-based services; 2) providers will use trauma-informed assessments and services and will be specifically treating identified trauma via EBP for consumers that consent to trauma treatment; 3) improve networking and availability of key resources and positive social engagements (housing, transportation, social connectedness, engagement with recovery services outside of the treatment center); and, 4) improve outreach and retention efforts to increase resources and common policy within and between participating providers in both counties. Each goal has from 3-8 objectives that will further measure the goal statements. To develop a sustainable mat program, ground IT in data/information, and to maximize efficiency and impact, we will document the process by completing and updating a needs assessment, necessary due to serious fragmentation and communication issues that impede OUD/SUD treatment, referrals, and communication in the target counties and widely held belief systems that stigmatize OUD as a non-disease process. An implementation plan to ensure fidelity to the program and ebps used as well as processes for all stated objectives and performance measures. An evaluation plan that will focus on data management, process, fidelity, performance measures, goals/objectives, and will include a mixed methods approach. A sustainability plan critical to maintain new levels of communication and resource sharing between providers as well as improving community understanding of OUD and networking resources.