SAMHSA Block Grants Now Tied to Medication-Assisted Treatments Like Suboxone

By John Lavitt 09/03/15

The move will allow states to supply buprenorphine drugs like Suboxone to people suffering opioid abuse disorder.

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In a landmark move towards a reformation of treatment modalities, the Substance Abuse and Mental Health Services Administration has added specific clauses in state block grant applications to support medication-assisted treatment (MAT) options like Suboxone.

A direct response to the opioid epidemic, the new grant applications are attempting to overcome the dominant abstinence model. As the federal agency responsible for most public funding of drug addiction treatment, this backing of the MAT model represents a strong endorsement of evidence-based treatment modalities.

Given the influence of 12-step groups, treatment for substance abuse disorders in the United States has been aligned with the abstinence model for decades. The abstinence model is the belief that abstaining from all drugs, including medications prescribed specifically for addiction, is the only viable path to sustainable recovery. In a rejection of this status quo, the new grant language from SAMHSA states:

“There is a voluminous literature on the efficacy of [Food and Drug Administration]-approved medications for the treatment of substance use disorders. However, many treatment programs in the U.S. offer only abstinence-based treatment for these conditions. SAMHSA strongly encourages the states to require that treatment facilities providing clinical care to those with substance use disorders be required to either have the capacity and staff expertise to use MAT or have collaborative relationships with other providers such that these MATs can be accessed as clinically indicated for patient need.”

Beyond a simple recommendation, the clear implication of the new language is that state grants will be tied to the widespread offering of medication-assisted treatment. The new language is a prominent part of SAMHSA's block grant application for fiscal years 2016-17. The financing available through these block grants is significant. In fiscal year 2015, the agency had $1.8 billion to award.

Although many treatment providers strongly disagree with the federal recommendation, the suggestion will carry weight. Among the medical establishment, medication-assisted treatment like the use of buprenorphine, widely known by the brand name Suboxone, for opioid abuse disorders is now viewed as the standard of care in many facilities, including Hazelden Betty Ford.

Still, the vast majority of rehabilitation facilities across the country fail to offer such care. In light of this latest update, such a lack is likely to be filled.

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Growing up in Manhattan as a stutterer, John Lavitt discovered that writing was the best way to express himself when the words would not come. After graduating with honors from Brown University, he lived on the Greek island of Patmos, studying with his mentor, the late American poet Robert Lax. As a writer, John’s published work includes three articles in Chicken Soup For The Soul volumes and poems in multiple poetry journals and compilations. Active in recovery, John has been the Treatment Professional News Editor for The Fix. Since 2015, he has published over 500 articles on the addiction and recovery news website. Today, he lives in Los Angeles with his beautiful wife, trying his best to be happy and creative. Find John on Facebook, Twitter, and LinkedIn.

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