Medication-Assisted Therapy

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Medication-Assisted Therapy

• Vivitrol

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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

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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

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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

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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

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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

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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 dont go on to offend again)
• Supported with DUII funding

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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

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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

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DAS IDP Vivitrol Pilot

• 100 voluntary participants
• DUI multiple offender
• Alcohol Dependent Diagnosis
• DUII eligible
• Present and admitted for alcohol detoxification

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Supplemental Services Available to Pilot
Participants

• Physician and Patient Education
• Up to six injections per client while in
  treatment
• Medical visits

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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

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Study the Impact

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

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Questions/Feedback
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Who to Contact?

• Vicki Fresolone
• Director of Treatment Services
• Vicki.Fresolone_at_dhs.state.nj.us
• Ann Wanamaker
• Assistant Chief, Intoxicated Driving Program
• Ann.Wanamaker_at_dhs.state.nj.us
• Lisa Mojer-Torres, Consumer Advocate
• Lisa.Mojer-Torres_at_dhs.state.nj.us