Under the Rural Opioid Technical Assistance grant, administered by Montana State University Extension between 2018–2020, six tribes participated. Two technical assistance trainings were held, and each training was designed to meet the needs of the participating tribes. Presenters shared information, technical knowledge, or support resources related to the implementation of Medication Assisted Treatment (MAT) services locally. This document summarizes the information shared during these trainings. 

 

Common Data Sources:

Several state and national data sources can be used to tell your community’s data story. 

Quality data sources include: 

• TRAC I Peer Recovery                   

• U.S. Census                     

• Web-based Injury Statistics Query and Reporting System 

• Youth Risk Behaviors Surveillance System

• American Community Survey

• National Immunization Survey

• Rural Health Information Hub 

• Indian Health Service Units’ Epi Data Mart

• MT DPHHS Vital Statistics

• Behavioral Risk Factor Surveillance System

• Child Health Measures

• Montana Cancer Tumor Registry

• SAMHSA National Survey of Drug Use and Health

• Surveillance, Epidemiology, and End Results

Opioid Treatment Program vs. Office-based Opioid Treatment

Opioid Treatment Program (OTP) An outpatient program which provides comprehensive treatment services including pharmacological treatment for opioid use disorders.

• Program is licensed by the DEA to dispense Methadone, Suboxone (buprenorphine/naloxone), Subutex (buprenorphine), or Vivitrol (Naltrexone) - XR can be provided by prescription

• Can only dispense Methadone out of an OTP

• Methadone take homes are not allowed unless earned after several weeks of compliant program attendance with negative drug screens and compliance with the treatment plan developed with the patient and their counselor

• Patients initially go to the clinic 6 days a week for a nursing evaluation and observed dosing. Patients in the initial phase of treatment only take doses out of the clinic one day per week

• The clinic dispenses medication and a nurse observes its use

• Monthly counseling and medical provider appointments  are required

• Accredited by SAMHSA/CARF to provide MAT with all FDAapproved medications

• No limit on number of patients who can be treated

• Medications dispensed are not reported to State Prescription Drug Monitoring Programs (PDMPs)

vs.

Office-based Opioid Treatment (OBOT) Substance use disorder treatment via primary care and  general health care settings, and come specialty practices.

• Patients are seen by a medical provider with a DATA-waiver to prescribe Suboxone (buprenorphine/naloxone), Subutex (buprenorphine), or Vivitrol (Naltrexone)

Prescriptionspatientfillsitattheirpharmacy

• Prescriptions are often written for a 28-day supply, and can have upto5refills

• No prescriptions for Methadone

• No federal requirement for counseling, but is recommended for improved outcomes

• Diversion calls are typically not done

Waiveredprovidersarelimitedto30patientsintheirfirstyear,can apply for 100 patients in special circumstances, and can apply to see 275 patients after 2 years

 

Family Support Programs for OUD

• Family support programs are organized to build on community strengths and resilience, provide family support for relatives who are struggling, and provide education and support to family members.