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 recoveryTo this end DAS hopes to promote evidence based practices in the treatment of addictionsOne initiative in this area is the planned Vivitrol pilotThe DAS goal is to develop a system of care….
3 Division of Addiction Services Vivitrol Pilot Objective:Support and extend continuous abstinenceAfford client opportunitystabilization during treatmentacquire skills necessary to independently support recoverytransition into Recovery Zone
4 Medication Assisted Therapy What is Vivitrol? Vivitrol is injectable Naltrexone with the following benefits:Works well with counselingReduces cravingsDecreased impulsivityEnhanced motivationImproved treatment adherenceSingle injection is effective for four weeks - Eliminates daily adherence decisionsRapid onset of therapeutic effect in the first 2 daysGenerally well tolerated with a demonstrated safety profileOral NaltrexoneBenefits to Naltrexone, however, compliance is a concern with daily dosing.
5 Vivitrol Injectable form of Naltrexone Once monthly dosing FDA approved 2006Manufactured by Alkermes, Inc.An Evidence Based Practice - SAMHSA Treatment Improvement Protocol #49: “Incorporating Alcohol Pharmacology into Medical Practice”What is Vivitrol
6 Journal of Substance Abuse Treatment January 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 holidaysOpportunity to deal with the special dangers of alcohol-impaired driving
7 Choosing the Pilot Cohort DUI PopulationHigher rate of alcohol as primary drug of choiceLooking for evidence of a decrease in DUI offenses (clients don’t go on to offend again)Supported with DUII fundingIn review of the NJSAMS it was identified that in one year…
8 Choosing the Pilot Cohort Of clients with primary alcohol diagnosis admitted in NJSAMS:3,700 admitted to detoxification985- at least one DUI offense423- more than one episode of detoxification288- both multiple detoxification andmultiple DUI offenses
9 Goals for DUI offender participants: DAS IDP Vivitrol PilotGoals for DUI offender participants:Period of stabilization in which to embark upon recoveryReduction or elimination of DUI offensesDecrease of additional detoxification episodes
10 DAS IDP Vivitrol Pilot 100 voluntary participants DUI multiple offenderAlcohol Dependent DiagnosisDUII eligiblePresent and admitted for alcohol detoxificationCriteria for eligibility in the pilot. First injection at detox discharge offers the client awaiting a referral to the next level of care offers a benefit and incentive to compliance with the next level of care.
11 Supplemental Services Available to Pilot Participants Physician and Patient EducationUp to six injections per client while in treatmentMedical visitsThe pilot is funded by the DUII and in addition to treatment, includes:
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 servicesClients receive initial injection at discharge from detoxificationFollow up injections and continuing care treatment at a DUII/ Vivitrol Provider AgencyDUII will reimburse for the medication and all servicesDAS will develop a network of providers that have capability of providing both the appropriate level of care and medical staff to provide the injections. The initial injection will occur at detoxification and the additional injections are at the next level of care. If a client completes treatment prior to the completion of injections, twice monthly individual sessions with counselor are needed to continue with the Vivitrol medication.
13 Study the Impact Pursuing offer from CSAT to assist with outcome study Study will assessClient outcomesCosts