This program aims to address the opioid crisis by increasing access to medication-assisted treatment using the three FDA-approved medications for the treatment of opioid use disorder, reducing unmet treatment need, and reducing opioid overdose related deaths through the provision of prevention, treatment and recovery activities for opioid use disorder (OUD) (including illicit use of prescription opioids, heroin, and fentanyl and fentanyl analogs). This program also supports evidence-based prevention, treatment and recovery support services to address stimulant misuse and use disorders, including for cocaine and methamphetamine. These grants will be awarded to states and territories via formula. The program also includes a 15 percent set-aside for the ten states with the highest mortality rates related to drug poisoning deaths.
Recipients will be required to do the following: use epidemiological data to demonstrate the critical gaps in availability of treatment for OUDs in geographic, demographic, and service level terms; utilize evidence-based implementation strategies to identify which system design models will most rapidly and adequately address the gaps in their systems of care; develop an infrastructure to deliver evidence-based treatment interventions that include medication(s) which FDA-approved specifically for the treatment of OUD, and psychosocial interventions in a continuum of care that includes outpatient services at a variety of intensities based on individual need including centers of excellence that focus on integrated care services that address OUD and co-occurring medical/mental illnesses, opioid treatment programs, intensive outpatient services, specialty addiction medicine/psychiatry treatment services, primary care-based substance use disorder services, inpatient acute care services, recovery housing and community-based recovery services; report progress toward increasing availability of medication-assisted treatment (MAT) for OUD; increasing engagement and retention in treatment, and reducing opioid-related overdose deaths.
The use of these funds requires that only evidence-based treatments, practices and interventions for OUD be used by recipients and subgrantees. SAMHSA requires that FDA-approved MAT be made available to those diagnosed with OUD. FDA-approved MAT for OUD includes methadone, buprenorphine products, including single-entity buprenorphine products, buprenorphine/naloxone tablets, films, buccal preparations, long-acting injectable buprenorphine products, buprenorphine implants, and injectable extended-release naltrexone. Medical withdrawal (detoxification) is not the standard of care for OUD, is associated with a very high relapse rate, and significantly increases an individual's risk for opioid overdose and death if opioid use is resumed. Therefore, medical withdrawal (detoxification) when done in isolation is not an evidence-based practice for OUD. If medical withdrawal (detoxification) is performed, it must be accompanied by injectable extended-release naltrexone to protect such individuals from opioid overdose in relapse and improve treatment outcomes.
Grantees of this funding must fulfill the following required activities:Grantees must use SAMHSA's Opioid STR grant funds primarily to support prevention, treatment, and recovery support activities. This includes the following required activities: