Use of Pharmacotherapies by Substance Abuse Treatment Facilities

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1 Use of Pharmacotherapies by Substance Abuse Treatment Facilities Cathie E. Alderks, PhD Substance Abuse and Mental Health Services Administration Department of Health and Human Services November

2 The National Survey of Substance Abuse Treatment Services Annual survey of all organized substance abuse treatment facilities known to SAMHSA Collects information on location, characteristics, and services offered one-day census of clients in treatment Mixed mode: mail, web, telephone 2

3 Number of Substance Abuse Treatment Facilities Responding to the Survey Pharmacotherapies/ Prescription Medication Number of Facilities (in thousands) Specific Drugs Mentioned Number of Substance Abuse Treatment Facilities Number Offering Any Queried Pharmacotherapy Number Dispensing Methadone/LAAM/Buprenorphine 3

4 Facilities Offering Antabuse, Naltrexone, or Campral 4

5 Specific Pharmacotherapies Antabuse: (disulfiram) The first pharmacotherapy approved for the treatment of alcohol abuse and alcohol dependence by the U.S. Food and Drug Administration. Causes unpleasant side effects if alcohol is consumed. Naltrexone: (naltrexone hydrochloride) An opioid receptor antagonist used primarily in the management of alcohol dependence and opioid dependence. Reduces the craving and blocks the high for alcohol and blocks the high of opioids. Campral : (acamprosate calcium) FDA-approved for the maintenance of abstinence from alcohol in patients with alcohol dependence who are abstinent at treatment initiation. Reduces the physical distress and emotional discomfort (withdrawal symptoms) people usually experience when they quit drinking. 5

6 Percent of Facilities Offering Antabuse, Naltrexone, or Campral percent Any Antabuse Naltrexone Campral

7 Percent of Facilities Offering Antabuse, Naltrexone, or Campral by Ownership of Facility 80 percent Tribal Govt Private non Profit Private for Profit 15 Local Govt State Govt Federal Govt Antabuse Naltrexone Campral 7

8 Antabuse, Naltrexone, or Campral by Type of Treatment Offered by the Facility: % total facilities 67.2% 16.8% 9.3% 1.9% 0.3% 3.0% 1.4% 80 percent % Facilities Offering Any of Three Pharms OP Only RC Only OP & RC HI Only RC & HI OP & HI OP & RC & HI OP = Outpatient HI = Hos pital Inpatient RC = Residential % of facilities in type that offer : Antabuse Naltrexone Campral 8

9 Facilities Offering Methadone, LAAM, or Buprenorphine 9

10 Specific Pharmacotherapies LAAM: (Levo-Alpha Acetyl Methadol ) Blocks the effects of other opiates and prevents withdrawal, but does not produce a subjective high. Production discontinued in 2003 (severe cardiac-related adverse events). Methadone: A synethetic opioid used medically as an analgesic and in the treatment of narcotic addiction. Reduces withdrawal symptoms in people addicted narcotics without causing the "high" associated with the drug addiction. Buprenorphine: Subutex (buprenorphine hydrochloride) and Suboxone (buprenorphine hydrochloride and naloxone hydrochloride). Subutex and Suboxone treat opiate addiction/dependence by preventing symptoms of withdrawal from heroin and other opiates. Approved by FDA in October

11 Opioid Treatment Program An Opioid Treatment Program (OTP) is a substance abuse treatment program that is certified by SAMHSA s Center for Substance Abuse Treatment (CSAT) to use opioid drugs such as methadone or buprenorphine in the treatment of opiate (narcotic) addiction. 11

12 Number of Opioid Treatment Programs (OTPs) 1,250 1,000 Number SAMHSA Certification of OTPs Number of OTPs 12

13 Opioid Treatment Programs by Ownership 60 SAMHSA Certification of OTPs percent Private For Profit Private Non Profit Local Govt State Govt Federal Govt Tribal Govt

14 Opioid Treatment Programs by Type of Program (Maintenance, Detox, or Both) percent Both Maintenance and Detox Maintenance Detox 14

15 Types of Treatment Offered by Facilities that Offer OTPs : Percent of OTPs % of OTPs are in facilities that offer Outpatient Treatment OP Only OP & RC OP & HI OP & RC & HI HI Only RC Only RC & HI OP = Outpatient HI = Hospital Inpatient RC = Residential 15

16 Pharmacotherapies Offered by OTPs percent Methadone Buprenorphine (any) Psychiatric Pharm Antabuse Nicotine Replace Naltrexone Campral LAAM 16

17 Total Number of Clients in Treatment Who are Receiving Opioid Replacement Therapy at Opioid Treatment Programs (OTPs) on Point Prevalence Date Thousands 300 SAMHSA Certification of OTPs Number Methadone LAAM Buprenorphine 17

18 How can you find facilities that have Opioid Treatment Programs? 18

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Various therapies are used in the

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