1. Medication-Assisted Therapy
Vivitrol

2. Division of Addiction Services Vivitrol Pilot
Overall DAS has a goal to develop a system of care that consistently offers clients the means to enter and sustain recovery
To this end DAS hopes to promote evidence based practices in the treatment of addictions
One initiative in this area is the planned Vivitrol pilot
The DAS goal is to develop a system of care….

3. Division of Addiction Services Vivitrol Pilot
Objective:
Support and extend continuous abstinence
Afford client opportunity
stabilization during treatment
acquire skills necessary to independently support recovery
transition into Recovery Zone

4. Medication Assisted Therapy What is Vivitrol?
Vivitrol is injectable Naltrexone with the following benefits:
Works well with counseling
Reduces cravings
Decreased impulsivity
Enhanced motivation
Improved treatment adherence
Single injection is effective for four weeks - Eliminates daily adherence decisions
Rapid onset of therapeutic effect in the first 2 days
Generally well tolerated with a demonstrated safety profile
Oral Naltrexone
Benefits to Naltrexone, however, compliance is a concern with daily dosing.

5. Vivitrol Injectable form of Naltrexone Once monthly dosing
FDA approved 2006
Manufactured by Alkermes, Inc.
An Evidence Based Practice - SAMHSA Treatment Improvement Protocol #49: “Incorporating Alcohol Pharmacology into Medical Practice”
What is Vivitrol

6. Journal of Substance Abuse Treatment January 2009
“The Effects of Extended-release Naltrexone on Holiday Drinking in Alcohol-dependent Patients”
With Vivitrol:
Better able to avoid episodes of heavy drinking during the holidays
Opportunity to deal with the special dangers of alcohol-impaired driving

7. Choosing the Pilot Cohort
DUI Population
Higher rate of alcohol as primary drug of choice
Looking for evidence of a decrease in DUI offenses (clients don’t go on to offend again)
Supported with DUII funding
In review of the NJSAMS it was identified that in one year…

8. Choosing the Pilot Cohort
Of clients with primary alcohol diagnosis admitted in NJSAMS:
3,700 admitted to detoxification
985- at least one DUI offense
423- more than one episode of detoxification
288- both multiple detoxification and
multiple DUI offenses

9. Goals for DUI offender participants:
DAS IDP Vivitrol Pilot
Goals for DUI offender participants:
Period of stabilization in which to embark upon recovery
Reduction or elimination of DUI offenses
Decrease of additional detoxification episodes

10. DAS IDP Vivitrol Pilot 100 voluntary participants
DUI multiple offender
Alcohol Dependent Diagnosis
DUII eligible
Present and admitted for alcohol detoxification
Criteria for eligibility in the pilot. First injection at detox discharge offers the client awaiting a referral to the next level of care offers a benefit and incentive to compliance with the next level of care.

11. Supplemental Services Available to Pilot Participants
Physician and Patient Education
Up to six injections per client while in treatment
Medical visits
The pilot is funded by the DUII and in addition to treatment, includes:

12. DAS IDP Vivitrol Pilot How It Works
DUII Network of Vivitrol Providers as a subset of DUII Network who will be trained and eligible for reimbursement for pilot services
Clients receive initial injection at discharge from detoxification
Follow up injections and continuing care treatment at a DUII/ Vivitrol Provider Agency
DUII will reimburse for the medication and all services
DAS will develop a network of providers that have capability of providing both the appropriate level of care and medical staff to provide the injections. The initial injection will occur at detoxification and the additional injections are at the next level of care. If a client completes treatment prior to the completion of injections, twice monthly individual sessions with counselor are needed to continue with the Vivitrol medication.

13. Study the Impact Pursuing offer from CSAT to assist with outcome study
Study will assess
Client outcomes
Costs

14. Questions/Feedback

15. Who to Contact? Vicki Fresolone Director of Treatment Services
Ann Wanamaker
Assistant Chief, Intoxicated Driving Program
Lisa Mojer-Torres, Consumer Advocate