1 Use of Pharmacotherapies by Substance Abuse Treatment Facilities November 2007 Cathie E. Alderks, PhD Substance Abuse and Mental Health Services Administration Department of Health and Human Services

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

3 Number of Substance Abuse Treatment Facilities Responding to the Survey Pharmacotherapies/ Prescription Medication Specific Drugs Mentioned

4 Facilities Offering Antabuse, Naltrexone, or Campral

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.

6 Percent of Facilities Offering Antabuse, Naltrexone, or Campral

7 Percent of Facilities Offering Antabuse, Naltrexone, or Campral by Ownership of Facility

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

9 Facilities Offering Methadone, LAAM, or Buprenorphine

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 2002

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.

12 Number of Opioid Treatment Programs (OTPs) SAMHSA Certification of OTPs

13 Opioid Treatment Programs by Ownership SAMHSA Certification of OTPs

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

15 Types of Treatment Offered by Facilities that Offer OTPs : 2006 OP = Outpatient HI = Hospital Inpatient RC = Residential 92% of OTPs are in facilities that offer Outpatient Treatment

16 Pharmacotherapies Offered by OTPs

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

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

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