Integrating Medications for Addiction Treatment into Assertive Community Treatment teams: A pilot feasibility study.

Abstract Background and Objectives: Medications for Addiction Treatment (MAT) are available and effective. Yet their utilization remains suboptimal, especially in community mental health settings. With persisting high mortality and morbidity related substance use disorders (SUDs), there is need to increase identification of SUDs, access to and utilization of MATs through capacity building among clinicians in clinical settings where patients already access care. Methods: We provided MAT training for clinicians in 10 Assertive Community Treatment (ACT) teams and rolled out SUD screening, assessment and treatment for their patients through a multi-component “MAT-In-ACT” intervention. Using a prospective quasi-experimental study design, participants who were positive for SUDs on standard questionnaires were evaluated and recommended for appropriate FDA-approved MATs and connected to a prescriber. Results: All 10 ACT teams implementedMAT-in-ACT intervention protocol with intervention fidelity of 80%. Of all active ACT clients (N=622), more than half (54.7%) agreed to participate in the study (n=340). Of these, 225 met the criteria for at least one SUD (66.2%) out of which 78 participants (34%) received at least one medication for addiction treatment. Discussion: This study successfully integrated SUD screening, assessment, and prescription of MATs by non-addiction specialists into community ACT programs for people with severe and persistent mental illness. Conclusion: Access to MATs can potentially be increased by focusing on existing community mental health care settings that traditionally do not prescribe them for their patients.