1. VIVITROL INJECTIONS IN CONJUNCTION WITH THE WARREN COUNTY JAIL Coordination at many levels

2. THERE’S A SHOT FOR THAT… 1. Discuss the mechanism of Vivitrol and explain the different types of MAT approaches: agonist, antagonist, and partial agonist 2. Discuss the planning and implementation of the pilot project Solutions created for use of Vivitrol in the Warren County Jail and the relationships that were vital for that to happen 3. Discuss where the Solutions MAT project with Vivitrol at the jail is currently and where they intend to grow that facet of service and how others could use what they have learned in their own planning

3. THREE TYPES OF MAT Agonist Partial Agonist Antagonist Feels like we are back in HS literature, just kidding…. terminology

4. OTHER TERMS TO BEGIN WITH Opiate- properly limited to the natural alkaloids found in the resin of the opium poppy (Papaver somniferum) Opioid refers to both opiate and synthetic substances Opioid- any chemical that resembles morphine or other opiates in pharmacological effects. Opioids work by binding to opioid receptors, found in the CNS and PNS and GI tract. These receptors mediate the beneficial effects as well as the psychoactive and the side effects of opioids.

5. WHY ARE THEY USED They work… Among the world’s oldest known drugs; use of the opium poppy predates recorded history Analgesic (painkiller) effects of opioids due to decreased perception of pain, decreased reaction to pain as well as increased pain tolerance Side effects include: sedation, respiratory depression, constipation, And a strong sense of euphoria Can cause cough suppression, sometimes as an unintended side effect

6. ALSO CAN CAUSE…. Dependence, which develops with ongoing administration This can lead to withdrawal symptoms

7. AGONIST Mimic the effects of naturally occurring endorphins in the body and produce an opiate effect by interacting with the opioid receptor sites; ex: Methadone and LAAM

8. PARTIAL AGONIST Partial opiate agonists attach to and activate opioid receptors

9. ANTAGONIST Competitive chemicals that have bind to the opioid receptors with higher affinity but do not activate the receptors

10. VIVITROL Injectable form of naltrexone Effectively blocks the receptor, preventing the body from responding to opiates and endorphins Relapse prevention medication?

11. SUBOXONE Buprenorphine used as an alternative to methadone for long-term opiate substitution Work to reduce or eliminate opiate withdrawal Also contains naloxone which works to reduce the impact buprenorphine has on the individual’s receptors for opioids

12. NALOXONE Overdose reversal use Higher affinity, knocks the opioid off the receptor site for a time

13. SUBUTEX Similar to Suboxone, with out the naloxone

14. METHADONE Synthetic opiate Federally mandated clinics

15. BRIEF HISTORY OF THE WARREN COUNTY EXPERIENCE Alkermes located in Wilmington FDA approval State funding, through MHRS board Pilot project at the jail Continued use in jail in community Expansion Addition of Narcan Creative funding… Partnerships