Montana expands stimulant use disorder treatment
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HELENA — Governor Greg Gianforte and Department of Public Health and Human Services Director Adam Meier announced Montana has contracted with six treatment providers to pilot an integrated, evidence-based program to expand the State’s capacity to treat stimulant use disorders, such as methamphetamine use, and fill a much-needed gap in the behavioral health continuum of care.
Providers are now working to implement the components of the new program called TReatment of Users of STimulants (TRUST) and are beginning to serve clients. Over the next two years, up to 420 clients could receive treatment in the program.
“The impact that meth and other stimulants have in Montana is immense,” Governor Gianforte said. “The drug crisis we face is ripping apart our families and devastating our communities. It’s critical we invest in treatment to effectively address the impact of these toxic substances on the brain and to support patients in their long-term recovery from this chronic illness. I appreciate the effort that has gone into launching TRUST, and look forward to following the progress in the months and years ahead.”
The program is an important piece of Governor Gianforte’s Healing and Ending Addiction through Recovery and Treatment (HEART) Initiative. The HEART Initiative directs state and federal funding to expand the State’s behavioral health continuum. TRUST is funded primarily through a near $1 million federal grant from the Substance Abuse and Mental Health Services Administration. The state has also proposed in the HEART Waiver to use Medicaid funding to cover this evidence-based practice upon federal approval. This would make the program more widely available.
Six treatment providers are included in year one of the pilot project.
TRUST is a multi-component program that uses behavioral health strategies with evidence of efficacy in assisting individuals to reduce and/or discontinue their stimulant use. The program is designed for an initial 12-week intensive intervention, followed by up to nine months of assistance to support continued recovery and stabilization.
It aims to increase access to quality treatment for methamphetamines and other stimulants, support long term recovery, and reduce the risk of overdose and overdose death.
The program incorporates contingency management, cognitive behavioral therapy, community reinforcement approach, motivational interviewing, physical exercise, and self-help mutual support.
Stimulant use disorders include a range of problems associated with the use of methamphetamine, cocaine, and other amphetamines leading to clinically significant impairment or distress, from mild to severe.
Several key statistics describe the impact in Montana:
While opioids still account for the largest percentage of drug overdoses in the state, methamphetamine related deaths, hospitalizations and emergency department visits in Montana have increased over the last few years. Approximately 12,900 adolescent and adult Montanans used methamphetamine in the period 2009 - 2019.
In 2019, the annual methamphetamine-related death rate in Montana was 7.2 per 100,000 people, exceeding the national average of 5.7 per 100,000 people.
Furthermore, over 65 percent of Child and Family Services Division substance-use related placements list methamphetamine as the primary drug.
Meier estimates that approximately 79,000 Montanans have a substance use disorder, realistically only a fraction of these people would seek treatment in any given year.
DPHHS will expand the pilot project by contracting with another six new treatment providers by January 2022. Eligible treatment providers can apply to become a TRUST pilot site by responding to a Request for Proposal that will be released in October 2021. If TRUST is approved for
Medicaid billing, many more sites could be added in the coming years.
“The pilot project will provide DPHHS the opportunity to test out the program across the state in a number of different provider settings, and evaluate its efficacy in treating stimulant use disorders,” Meier said.
Meier said client success will be measured by a reduction in mental health symptoms, decreased use of stimulants, increased retention in treatment, changes in risky behaviors, decreased criminal justice involvement, and positive changes in overall health, including social connectedness and quality of life.
