Description
The Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (CSAT) is accepting applications for fiscal year (FY) 2013 Cooperative Agreement for the Physician Clinical Support System - Medication Assisted Treatment grant. The purpose of this program is to build upon the current SAMHSA-funded Physician Clinical Support System Buprenorphine (PCSS-B) , a national mentoring network offering support (clinical updates, evidence-based outcomes and training) by expanding the focus on buprenorphine to include the other two FDA approved medications for the treatment of opioid addiction, methadone and extended release naltrexone and increasing the amount of training for office based physicians and opioid treatment program medical professionals. The program will provide up to date and evidence-based information to support training of health professionals and to address complex issues of addiction. In October 2002, the Food and Drug Administration (FDA) approved buprenorphine (Subutex ®) and buprenorphine combined with naloxone (Suboxone ®) as sublingual tablet preparations indicated for detoxification and long-term therapy in opioid dependency. These are the only two schedule III medications approved by the FDA for treatment of opioid addiction under the Drug Addiction Treatment of 2000. Subsequently, SAMHSA established the PCSS-B to (a) support physicians in the workforce who are providing buprenorphine treatment, (b) promote strategies that address practical issues in the recognition and treatment of opioid addiction through the use of multiple training formats and technologies, (c) target primary care physicians who are trying to integrate opioid addiction into their practice, and (d) provide advanced training that addresses more complex issues in the treatment of opioid use disorders. More recently, on October 12, 2010, the FDA approved extended release injectible naltrexone (Vivitrol ®) to treat and prevent relapse after patients with opioid dependence have undergone detoxification treatment. Extended release injectible naltrexone is a non-narcotic product that provides an alternative to the two more widely used and controlled substances, methadone (schedule II) and buprenorphine. While there has been a significant increase in the number of persons who have been prescribed buprenorphine for opioid addiction treatment in the past several years, the number of people who have been inducted on extended release injectible naltrexone remains relatively low in part due to the lack of education and knowledge by primary care physicians about opioid addiction and this medication. Thus, training in the appropriate use and indications for extended release injectible naltrexone is highly needed. The overall lack of physician training, concerns over practical issues, and limited understanding of the appropriate role of medication in opioid treatment also appear to be factors in the slow adoption of newer forms of opioid treatment by the medical profession. Thus, this program is designed to carry out the training of physicians desiring to prescribe and/or dispense FDA approved products (buprenorphine, methadone and naltrexone, including extended release injectible naltrexone) for the treatment of opioid addictive disorders. By enlisting the assistance of addiction medicine and psychiatry medical specialty organizations and other organizations that focus on opioid addiction, medication assisted treatment, and recovery from opioid addiction, the grantee will offer physicians, substance abuse specialists, and other health professions the information and consultation they need to provide safe, appropriate, and effective pharmacologic treatment for opioid dependence, thereby reducing resistance and barriers to the availability of treatment. The grantee will address medical and psychiatric co-morbidities that are highly prevalent in those with addictive disorders and which contribute to the complex nature of opioid addiction. SAMHSA has demonstrated that prevention works, treatment is effective, and people recover from mental and substance use disorders. Behavioral health is an essential part of health service systems and community-wide strategies that work to improve health status and lower costs for families, businesses, and governments. Continued improvement in the delivery and financing of prevention, treatment, and recovery support services provides a cost effective opportunity to advance and protect the Nations health. In order to achieve this goal, SAMHSA has identified eight Strategic Initiatives to focus the Agencys work on improving lives and capitalizing on emerging opportunities. The PCSS-MAT program addresses the Prevention of Substance Abuse and Mental Illness Strategic Initiative. One of the goals of this Strategic Initiative, which is consistent with the intent of PCSS-MAT, is to reduce prescription drug misuse and abuse through the education of current and future prescribers regarding appropriate prescribing practices for pain and other medications subject to abuse and misuse. More information is available at the SAMHSA website: http://www.samhsa.gov/About/strategy.aspx. The PCSS-MAT grant program is authorized under Section 509 of the Public Health Service Act, as amended. This announcement addresses Healthy People 2020 Substance Abuse Topic Area HP 2020-SA.