RD398 - Virginia Drug Treatment Courts: Substance Use Treatment Pilots – October 1, 2016

Executive Summary:
The Virginia Governor’s Task Force on Prescription Drug and Heroin Abuse was created to address the rising issue of prescription drug abuse as well as heroin use. The effects of such impacts every community across the Commonwealth and is an ever-growing problem. Medication-assisted treatments (MAT) have been proven to reduce relapse and rearrests. Vivitrol® has gained support to treat opioid use and alcohol use disorders. Results from pilot programs across the country show success using Vivitrol®. Participants have reported fewer side effects than with other treatments with both staff and participants reporting favoring over other medications. An Ohio study showed that six months following intake participant arrests for drug related offenses dropped from 80% to 50% (Baughman, M. & Singer, M., 2015).

The Task Force plan noted improvements were needed in access and availability to treatment service. Through the establishment of two pilot sites in the city of Norfolk and county of Henrico, access to less addictive treatments and to measure the outcomes would be provided. However, because of the varying coverage of Vivitrol® among Medicaid and private insurance providers, such access may not be completely possibly. Staff, healthcare providers and participants will need to be educated on coverage options for Vivitrol®. In other states, programs reported that although Vivitrol® had favorable outcomes, they were limited in what providers would provide thereby limiting options to receive treatment.

As the selected pilots, both adult drug treatment courts were requested to complete a grant application process in order to be approved, which included the following:

• A detailed description of the Vivitrol pilot program

• A copy of the Vivitrol Pilot Policy & Procedures Manual for their drug court program

• Compliance with the Medication-Assisted Treatment in Drug Courts Recommended Strategies, known as the Nine Components of Successful MAT Programs

• Compliance with the Medication Guide provided by Alkermes, the Vivitrol manufacturer For these and future pilot programs to be successful; staff, participants, and providers will also need:

• Education

• Training

• Funding

• Access

While the medication-assisted treatment is reported as successful, it cannot be discounted that when coupled with other ancillary services the positive outcomes are even greater. States have recognized that many participants have co-occurring issues including mental health, housing, childcare, transportation, and unemployment. For treatment to truly work, a community wide effort is needed. The two pilots will seek to address the lack of access and funding that so many drug treatment court programs experience while also encouraging multi-disciplinary approaches. These pilots will also provide guidance and support for other future programs.