Field of Work: Medication-assisted treatment for alcoholism

Problem Synopsis: Client data for 2005 showed that, for most providers in Missouri, alcohol was the drug most frequently used and abused by adult clients. None of the partner agencies in the state had used medication-assisted treatment for alcoholism before, although most were interested in trying it.

Synopsis of the Work: The goal was to increase the use of two medications approved for the treatment of moderate-to-severe alcoholism, naltrexone and acamprosate. They are called anti-craving drugs because they reduce the intoxicating efforts of alcohol and the urge to drink.

Participating treatment providers and state officials examined and corrected problems in their administrative systems that prevented people from accessing medications, trained staff and others in how medications work in supporting recovery, and secured funds to pay for medications.

Key Results:

• By the end of the two-year project, 299 patients received one or more prescriptions of naltrexone or acamprosate to support recovery. In 2005, before the project began, no consumers served by the partner agencies were receiving medication-assisted treatment for their alcoholism.
• The Division of Alcohol and Drug Abuse amended provider contracts to reimburse agencies for the services of physicians and advanced practice nurses who assessed clients and prescribed medications.
• The state designated $1 million annually for medication-assisted treatment, a commitment that has continued since the project ended, according to project staff. The Division of Alcohol and Drug Abuse developed a collaborative agreement with the Department of Corrections, which provided $500,000 to purchase medications for corrections-referred consumers on probation and parole, and promoted the use of naltrexone.