Paradise Ballroom B
Speaker(s):
Description
The overdose death crisis across the United States continues to worsen, despite some glimmers of hope in certain regions and in certain strategies. In Missouri, the State Targeted and State Opioid Response (STR/SOR) grants initiated in 2017 supported the development and implementation of the Medication First approach to opioid use disorder (OUD) treatment and demonstrated positive initial results. Medication First for OUD is a “low-barrier” treatment approach and is analogous to the Housing First approach to chronic homelessness; both prioritize rapid and permanent access to life-saving resources (housing for homelessness and treatment medications, particularly buprenorphine and methadone, for OUD).
Early findings from the first 18 months of Medication First implementation across Missouri’s state-funded substance use disorder treatment programs found uninsured clients enrolled in STR/SOR programs were more likely to receive medications for OUD (MOUD), to receive them faster, and to be retained in treatment significantly longer than uninsured clients enrolled in non-STR/SOR programs. However, subsequent analyses covering years 2019-2022 yield less straightforward results. For example, medication utilization has decreased within STR/SOR programs while increasing in non-STR/SOR programs (plateauing at approximately 60% of all uninsured clients combined receiving any form of MOUD), and disaggregation by race reveals notable racial disparities in treatment retention across timepoints.
This presentation will review statewide findings from STR/SOR treatment programs from the last five years, offer insights into why low-barrier MOUD treatment continues to be difficult to access and implement, reflect on lessons learned through Medication First dissemination, and provide tangible recommendations for Missouri’s future substance use treatment funding and programming endeavors.
Objectives
1. Describe a summary of broad trends of Missouri’s STR/SOR treatment outcomes from the last five years
2. List three specific barriers to implementing and sustaining low-barrier medical treatment for opioid use disorder within specialty substance use disorder treatment programs
3. Identify two strategies for reducing racial disparities and improving opioid use disorder treatment outcomes for Black individuals in Missouri