Using Knowledge to Build a More Responsive System for Individuals on Medication Assisted Treatment

Introduction: Opioid-related overdoses and deaths continue to increase across the United States, and the addiction service sector is stained by the growing need for opioid-related treatment and recovery services. Recent policy and funding initiatives have supported the increase of medication assisted treatments (MATs) to address this growing epidemic. This study used a University/community partnership model to assess the capacity of services along the addiction continuum of care to respond to growing needs for Opioid-related treatments and services for individuals using MATs. This study focused in on the findings around responsiveness of recovery housing to serving clients on various opioid maintenance medications.

Methods: To create a comprehensive Census of agencies providing services along the addiction continuum of care, we collected information from over 10 existing referral listings and online directories to create a census of potential existing services across the addiction continuum of care from September 2017 to March 2018 in the Kansas City metropolitan area. We triangulated information that was systematically pulled from the following 5 sources to identify facility location, services provide, capacity, populations served policies around MAT use, and faith-based orientation: (1) web/telephone survey, (2) stakeholder interviews, (3) web scrapes, (4) SAMHSA locator details, and (5) state and county licensing details. We identified 109 transitional housing facilities serving individuals in recovery across 10 counties that capture a mix of urban and rural geographies.

Results: All housing facilities were geographically clustered within five of the 10 counties, typically within more urbanized environments. Approximately 64% of facilities reported not accepting clients on MATs. Reasons varied from not having the structure to support individuals in recovery from opioids to associating MATs as a narcotic that goes against standards of drug free living to having poor experiences with clients on MATs. About 18% of facilities reported accepting clients on MATs with reservations, depending on client’s behaviors or type of MAT prescribed. Another 18% of facilities reported accepting clients on MATs without any reservations (translating to 292 total beds). The facilities support of MAT use were predominantly structured sober living environments, some have specialized supports for opioid-related needs, and are geographically clustered within the urban core of the Kansas City metropolitan area. Availability was even further restricted when demographics served by each facility were examined.

Conclusions: To support the individuals who are increasingly being prescribed MATs, providers along the addiction of continuum of care need to be actively engaged to understand their hesitations/concerns about treating this population and to be educated about the newer MATs available. This project developed models to engage the community and encourage the development of policies, funding priorities, and support structures for these individuals as they transition from treatment into the community. Implications include a discussion of University/community partnerships in timely responses to service needs and the importance of leveraging systematically collected data to proactively address community needs.