The purpose of this program is to expand/enhance access to medication-assisted treatment (MAT) services for persons with opioid use disorder seeking or receiving MAT. This program targets states identified with having the highest rates of primary treatment admissions for heroin and opioids per capita, and prioritizes those states with the most dramatic increases for heroin and opioids, based on SAMHSA’s Treatment Episode Data Set (TEDS): 2007 - 2013. The desired outcomes include: 1) an increase in the number of admissions for MAT; 2) an increase in the number of clients receiving integrated care/treatment; 3) a decrease in illicit opioid drug use at 6-month follow-up; and 4) a decrease in the use of prescription opioids in a non-prescribed manner at 6-month follow-up.
For the purpose of this FOA, integrated care/treatment is defined as the organized delivery and/or coordination of medical (including the use of Food and Drug Administration (FDA)-approved drugs [buprenorphine, methadone, naltrexone] for addiction), behavioral, social, peer, and other recovery support services provided to individual patients who have multiple healthcare needs in order to produce better overall health outcomes. MAT is defined as the use of FDA-approved opioid agonist medications (e.g., methadone, buprenorphine products, including buprenorphine/naloxone combination formulations and buprenorphine mono-product formulations) for the maintenance treatment of opioid use disorder and opioid antagonist medication (e.g., naltrexone products, including extended-release and oral formulations) in combination with behavioral therapies to prevent relapse to opioid use. MAT includes screening, assessment (which includes determination of severity of opioid use disorder, including presence of physical dependence and appropriateness for MAT), and case management. MAT is to be provided in combination with comprehensive substance use disorder treatment, including but not limited to: counseling, behavioral therapies, and, when needed, pharmacotherapy for co-occurring alcohol use disorder. MAT is to be provided in a clinically driven, person-centered, and individualized setting.
This program addresses SAMHSA’s Strategic Initiative on Health Care and Health Systems Integration. For more information on SAMHSA’s six strategic initiatives, you can visit http://www.samhsa.gov/about-us/strategic-initiatives. The MAT-PDOA program seeks to address behavioral health disparities among racial, ethnic, sexual, and gender identity minority populations by encouraging the implementation of strategies to decrease the differences in access, service use, and outcomes among the racial and ethnic minority populations served. (See PART II: Appendix G – Addressing Behavioral Health Disparities.)
The MAT-PDOA program is one of SAMHSA’s services grant programs. SAMHSA intends that its services grants result in the delivery of services as soon as possible after award. Service delivery should begin by the 4th month of the project at the latest.