One valuable sources of federal funding in the fight against opioid use disorder (OUD) (including prescription opioids, heroin and illicit fentanyl and fentanyl analogs) has been a Substance Abuse and Mental Health Services Administration (SAMHSA) grant called the State Targeted Response to Opioid Crisis Program -- STR funding for short.
The purpose of the STR program is to address the opioid crisis by increasing access to treatment, reducing unmet treatment need, and reducing opioid overdose related deaths through the provision of prevention, treatment and recovery activities.
The Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) was awarded $11,782,710 for year one (May 1, 2017 - April 30, 2018) and the same amount for year two (May 1, 2018 - April 30, 2019) of this two-year grant program.
Year one results
The first year of funding has yielded positive improvements in each of the three areas of focus: prevention, treatment, and recovery.
In the area of prevention there has been: training in naloxone administration and distribution of naloxone kits for 312 first responders and 3,255 citizens, which resulted in 435 self-reported overdose reversals; two new public service announcements (PSA) about Georgia's Good Samaritan law and naloxone availability, which have been played in more than 100 movie theatres statewide; and four service providers have been engaged to implement SAMHSA's Strategic Prevention Framework (SPF) model in four of the six DBHDD regions of the state, including Senate District 4.
In the area of treatment: the Office of Addictive Diseases contracted with nine providers for treatment - including Medication-Assisted Treatment (MAT) - of uninsured and underinsured Georgians who have opioid use disorders. Through this initiative, 450 individuals have received treatment. You may recall we covered MAT in a two-part column in December 2017.
In the area of recovery: three recovery initiatives have been added through the grant:
A peer warm line, staffed by trained people in recovery themselves, to support people who have an opioid use disorder by connecting them with individuals who have been through similar experiences;
Recovery coaching in two hospital emergency departments; and
Education for recovery residences to align with the various pathways to recovery.
Year two plans
The second year of the STR grant began May 1, 2018. DBHDD will double naloxone distribution to first responders to reverse the effects of overdose and give more people a second chance at life and recovery. DBHDD will also release two additional PSAs that promote self-advocacy and safe storage and disposal of prescription drugs. New MAT providers will be added to North Georgia, West Georgia, and the Metro Region to address service needs in those areas. Recovery coaches will be added in two additional hospital emergency departments and funding of three recovery community organizations to provide support to individuals seeking recovery.
Beyond current grant funds
DBHDD is already actively seeking out another funding opportunity from SAMHSA since the STR grant is expected to end April 30, 2019. A slim chance exists that SAMHSA will extend grant funding for additional years because the opioid crisis has traction and there is understanding that the opioid epidemic is real, but uncertainty at the federal level is a reality. Nevertheless, DBHDD has already begun the application process for a similarly named SAMHSA grant entitled State Opioid Response Grants (SOR), whose application is due August 2018. The anticipated award of SOR funds should allow for a continuation of activities similar to those of the STR award when/if that grant ends, with little to no disruption of services statewide.
State opioid response grant (SOR)
SOR is another project of up to two years. These grants will be awarded to states and territories via formula. Each state will receive no less than $4 million; Georgia is expected to receive approximately $19 million per year, which will allow for additional access to MAT using the three FDA-approved medications for the treatment of opioid use disorder.
Like the STR grant, there is no cost sharing or matching state funds required to draw down these federal funds. However, these grant funds simply cannot supplant state funds already put to work for similar activities. In other words, the STR funds ($11.8 million) and SOR funds ($19 million) are in addition to the $12,435,244 in new state general funds that were added to the FY2019 state budget in an effort to address this and all other substance misuse disorders, including the $4 million in new state funding to provide Addiction Recovery Support Centers.