IDHS/SUPR Director Laura Garcia welcomed the group.
Director Garcia gave the following updates:
- Dr. Rafael Rivera has accepted the Chief of Staff position at SUPR.
- Director Garcia shared the following updates on the State Overdose Action Plan (SOAP):
- In the last year, 33,000 people have received naloxone training, more than 2,000 doses of naloxone have been administered by non-emergency services personnel and more than 100,000 naloxone kits were distributed statewide.
- Between September 2021 - August 2022, the Illinois Helpline had approximately 183,000 website visits, 8,000 searches for SUD treatment and recovery services, 1,500 chats, 500 text messages, and 21,000 calls received, with over 15,000 referral calls made and completed.
- The Medication-Assisted Recovery (MAR) NOW pilot has been expanded statewide. MAR NOW connects Helpline callers to immediate treatment for opioid use disorder (OUD), including telephonic prescription and home induction for buprenorphine or same-day clinic appointments for MAR.
- SUPR is working with opioid treatment programs to identify overdose abatement strategies that can be supported with opioid settlement funds and block grants.
Sarah Pointer, PharmD, Clinical Director for the Illinois Prescription Monitoring Program (PMP), provided the following updates:
- Over 1,300 health care organizations are integrated with the PMP resulting in multiple integration sites and approximately 8 million queries per month.
- The PMP has extended work with university partners to expand academic detailing statewide. University partners also are assisting with analysis of PMP data, including updating prescribing trends and conducting a regional analysis of buprenorphine prescriptions.
- The PMP continues to focus efforts on improving patient data that is available to prescribers.
Leslie Wise, PhD, Epidemiologist, Division of Emerging Health Issues, Office of Health Promotion, gave the following updates:
- The Opioid Data Dashboard has been updated with finalized 2021 death data and recent Emergency Department data (up through August 2022). The most recent State Unintentional Drug Overdose Reporting System (SUDORs) data file will also be updated on the Dashboard. Compared to 2021, 2022 Quarter 1 data shows an increase in fentanyl and psychostimulant fatalities and a decrease in heroin, benzodiazepine, and alcohol fatalities.
- IDPH is currently working with multiple state agencies to create an opioid prescription disruption protocol to deter patients who currently have an opioid prescription from seeking unnecessary, additional prescriptions.
- Southern Illinois University Hospital is assisting with the development of a nonfatal toxicology pilot program that will explore factors that contribute to nonfatal overdoses.
Arvind Goyal, MD, Medical Director, discussed the following updates:
- The Drug Utilization Review Board has reduced initial opioid and benzodiazepine prescriptions' number of days/supply from 7 to 5 days, and 14 days, respectively.
- HFS is positioning itself to measure the value of all therapy beyond the outcomes of individuals prescribed medication under Medicaid. All interventions aimed at reducing opioid overdoses and deaths need to be linked to a measurable reduction in opioid overdoses and opioid-related deaths.
Improving Access to Care: Family Guidance Center's (FCG) Mobile Medication-Assisted Treatment (MAT) Unit
Ron Vlasaty, Chief Operating Officer & Dr. Maria Bruni, Senior Vice President, Family Guidance Centers (FGC), gave the following presentation on FGC's Mobile MAT Unit (see attached handouts):
- SAMHSA's Medication Assisted Treatment - Prescription Drug and Opioid Addiction (MAT-PDOA) grant program expands/enhances access to MAT services for persons who have OUD. In June 2021, the DEA lifted restrictions on mobile MAR which made it possible for existing Narcotic Treatment Programs (NTPs), like FGC, to establish mobile MAR units, pending DEA approval.
- FGC's MAT-PDOA project uses a mobile unit to expand access to MAR on Chicago's West and South Sides. All three FDA-approved medications for OUD treatment are available, as well as naloxone kit distribution. FGC's mobile MAT unit is staffed with a FGC physician, a licensed practical nurse (LPN), a recovery support specialist (RSS), and a driver/security officer. FGC also partners with several community-based organizations that provide outreach and other services to support the mobile unit. The FGC mobile unit only delivers the first dose of medication and then refers and transports (if needed) clients to community-based partners for ongoing MAR.
- From 1/23/22 - 7/27/22, 182 clients were served on the FGC mobile MAT unit. The majority (74%) were male and non-Hispanic Blacks (69%). Nearly all were unemployed (93%), 60% reported poor physical health, and 45% were homeless. All but one reported heroin use during the past 30 days, with an almost daily frequency of use.
- Of the 182 clients served on the mobile unit, 69% were successfully connected to ongoing treatment. Just over 75% of those successfully connected treatment began receiving services at FGC, while just under 25% began receiving services at another SUD/MAT provider organization. Follow-up (6-month) data collection has begun and is expected to be available end of January 2023.
- FGC is working with SUPR to establish a mobile MAR unit that will cover eight counties in central Illinois. Due to the limited availability of methadone treatment providers in central Illinois, it is anticipated that buprenorphine will be the primary MAR prescribed to central Illinois clients who use the mobile unit.
- Director Garcia encouraged agencies that are interested in mobile MAR work to please reach out to SUPR for information and resources.
COIP Mobile MOUD: Integrating MAR into a Street-based Harm Reduction Services Program - Sarah Messmer, MD, COIP Mobile MOUD Co-PI/UIC Assistant Prof. of Clinical Medicine and Pediatrics and Dave Jimenez, PhD, COIP Mobile MOUD Co-PI/Director of Community Outreach Intervention Projects
Sarah Messmer, MD, COIP Mobile MOUD Co-PI/UIC Assistant Professor of Clinical Medicine and Pediatrics & Dave Jimenez, PhD, COIP Mobile MOUD Co-PI/Director of COIP, gave the following presentation:
- The Community Outreach Intervention Projects, or COIP, employs the Indigenous Leader Outreach Model (ILOM) which has three main components: 1) hire people from the target population; 2) target social networks; and 3) use epidemiology and ethnography to guide intervention deployment.
- Through funding from CDPH and SUPR, COIP provides outreach harm reduction services to the West Side of Chicago, including syringe exchange, overdose prevention education, naloxone distribution, food and clothing, peer recovery coaches, and peer recovery case management services. COIP also operates a sobering tent in collaboration with West Side Heroin/Opioid Task Force and Prevention Partnership. The sobering tent serves as a safe place for people who use drugs (PWUD) to rest and recover after using drugs and to be monitored by outreach staff in case an overdose occurs.
- During FY 2021, COIP provided harm reduction services to 480 unique clients, naloxone to 840 individuals, and recovery support services to 181 unique clients. Between May - August 2022, 50 PWUD were monitored by the sobering tent program.
- In Spring 2021, COIP received funding from SUPR to implement mobile MAR services on their existing medical van. In partnership with FGC, COIP established its mobile MAR program, which is authorized to dispense buprenorphine. COIP dispenses buprenorphine dose packs from the van, which is essentially a week supply of medication, with approximately 6-8 dose packs dispensed per day.
- Between June 2021 - May 2022, 597 unique patients visited the van, of whom 33% received MAR services. These patients were long-term users who were more likely to snort rather than inject drugs.
- Future directions in patient care include intensified patient tracking and follow up, development of standardized social determinants of health screening and resources tool, and integration of comprehensive HIV and HCV care into the mobile van. Future directions in research include a comparative outcome analysis of patients who are dispensed MAR versus receiving prescriptions from the van and of low threshold buprenorphine from the van versus brick-and-mortar sites. Efforts are also underway to expand training for the next generation of providers to care for this population.
- IDHS/SUPR anticipates an announcement about the Opioid Settlement Remediation Fund Advisory Board in the next 2-3 weeks.
- On August 25th, leaders from OnPoint NYC gave a live presentation to the West Side community about the NYC Overdose Prevention Centers. The Perioperative Care Toolkit is now active on the Illinois Helpline website. Please reach out to Dr. Tanya Sorrell (Tanya_Sorrell@rush.edu ) for more information.