Pat Stilen, MSW
Co-Director, Mid-America ATTC
|Kansas City, home to the Mid-America ATTC at the
University of Missouri Kansas City
A decade ago, few people knew about the array of medications available to support persons in recovery from substance use disorders (SUDs). In the judicial and corrections arenas, if persons coming into jails and prisons were on medication to help mitigate drug cravings, these medications were immediately stopped. Having worked in a field where abstinence was the gold standard for clients, counseling staff from entry-level to supervisors were often suspicious about such medications, and sometimes downright resistant.
Many physicians didn’t get pre-service training in substance use disorders, didn’t see the need to know, and, frankly, didn’t care to work with “those” people. Policymakers were hesitant to add yet another layer of education, treatment and expenses to an already complex and siloed system. In order for the delivery system for SUD medications to be effective, not just the counseling profession, but all four legs of this stool, would need to work together: medical, behavioral health, judicial, and policymakers. There was an urgency to coordinate these groups as the opioid epidemic grew....counseling staff from entry level to supervisors were often suspicious about such medications, and sometimes downright resistant.
Setting the Groundwork for MAT Acceptance
The planning committee represented a variety of positions: SSA staff, SUD treatment providers, state chief medical directors/physicians, state probation and parole staff persons, drug court staff members, and Veterans Hospital medical staff. Since the state of Missouri was ahead in embracing and implementing MAT, Missouri’s SSA Director, Mark Stringer, provided an opening address. This was followed by a presentation on the science of addiction and how MAT reduces cravings by R. Corey Waller, MD, MS, a national expert in MAT and working with the complex patient.
Medication-Assisted Treatment: Promoting Tools for Successful Recovery
Through this series of symposia, over 1,700 professionals were made aware of the benefits of using MAT, state policymakers began to change funding strings... and some who were initially resistant became some of the most powerful spokespersons for moving MAT into systems.
The two-day event, Medication-Assisted Treatment: Promoting Tools for Successful Recovery, was an invitation-only, leadership-focused symposium where participants took part in discussion groups and were challenged to consider MAT as a viable treatment for SUDs. Other state-specific symposia followed using the same model: state leadership opening the event; a national physician expert such as R. Corey Waller, MD, MS, or Edwin Salsitz, MD, FASAM, providing scientific background; a social worker explaining how prescribers can work effectively in partnership with counselors; a panel of persons in recovery using MAT; and other breakout sessions on MAT-relevant topics. According to evaluations, one of the most effective components of this model was the panel of persons in recovery using MAT.
Between 2011 and 2016, Mid-America ATTC sponsored or co-sponsored eight MAT symposia throughout Region 7. Through this series of symposia, over 1,700 professionals were made aware of the benefits of using MAT, state policymakers began to change funding streams to require MAT as an option for treatment, and some who were initially resistant became some of the most powerful spokespersons for moving MAT into systems. Setting the groundwork for MAT acceptance and implementation in Region 7 took significant time, funding and staff energy. The outcome of Region 7 more willing to embrace this important treatment option was well worth the effort.