Introduction
2005 has been a remarkable year in AATOD’s evolution as we implemented a major research project involving 72 methadone treatment programs in 28 states; expanded our hepatitis-C training program into eight (8) new states, building on the work of our successful pilot project; guided programs in responding to displaced patients in the aftermath of Hurricane Katrina; provided guidance to programs in our nation as an HBO documentary hit the airwaves; expanded access to methadone treatment in different parts of the criminal justice system; and worked more strategically with our European and international associates in expanding accessto methadone/buprenorphine treatment throughout the world. Without any question, we have continued to fulfill the promise of AATOD’s October, 2001 Five- Year Plan, as we improved our methods of communicating with our treatment community and the general public. We have expanded our communication network, utilizing a more sophisticated database and website as we communicate more effectively and rapidly with treatment programs throughout the country. This has enhanced AATOD’s ability to keep our field unified through challenges and opportunities.

Opioid Use Study
AATOD implemented its three-year research initiative among 72 programs in 28 states through Purdue Pharma, L.P. funding. Following a lengthy planning process, we implemented a survey questionnaire, which has been voluntarily completed by patients as they are admitted to methadone treatment programs. National Development & Research Institutes, Inc. has been our research partner from the inception in developing the survey instrument and in analyzing all of the collected data. Between January September, 2005, AATOD has collected more than 5,000 completed surveys from the participating programs. The preliminary findings of this study were reported in the September 26, 2005 edition of Alcoholism and Drug Abuse Weekly. Seventy percent of the respondents are Caucasian and 45% of the patients reported employment as a major source of income. Both findings are new and significant. Seventy-one of the respondents indicated heroin as their primary drug of abuse and 81% reported lifetime misuse of prescription opioids. The most frequently used opioids in the month prior to being admitted to treatment were heroin (54%), Oxycodone (38%), Hydrocodone (32%), and methadone (22%).

Equally important, more than 77% of the primary heroin users reported they had injected the drug prior to treatment and 35% of primary prescription opioid abusers reported that they had injected their primary opioid drug as well.

The study has also yielded important findings with regard to the source of the primary drug. Approximately 82% of the respondents indicated that dealers were their most frequent source of obtaining the drugs with 50% indicating their friends/relatives were involved in accessing the drug and 30% of the drugs were obtained through physician prescription. This survey will continue over the course of 2006 and 2007, yielding critical trend data, which will be of interest to federal and state regulatory agencies in addition to assisting treatment programs in responding to the emerging clinical needs of the patient population.

Criminal Justice Project
AATOD has also made significant progress in increasing access to methadone/buprenorphine treatment in different parts of the nation’s
criminal justice system, utilizing funding through a Robert Wood Johnson Foundation Innovators Award combined with financial support through Mallinckrodt, Inc.

Maryland’s Department of Public Safety and Correctional Services implemented a new methadone treatment component in the Baltimore City Jail, effective July 1, 2005. The Orange County Jail continued to provide access to methadone treatment to its opioid addicted inmates through the Center for Drug-Free Living (a community-based OTP in Orlando) in addition to developing a buprenorphine treatment program for addicted inmates, who were not enrolled in an OTP at time of incarceration.

The Legal Action Center (AATOD’s policy partner in this three-year project), has worked successfully with the New York City Department of Corrections to increase access to training through probation departments in the Greater New York metropolitan area, so that probation officers will get access to methadone treatment programs in referring individuals in need of such care. While this component of the project is in its preliminary planning stages, this will be more fully reported during the April 25, 2006 plenary session on Criminal Justice during AATOD’s National Conference in Atlanta, Georgia. Commissioner Martin Horn of the New York City Department of Corrections will report on the progress that has been made in addition to Timothy Ryan, who is the Chief of Corrections for Orange County, Florida.

AATOD has also worked to encourage the development of methadone treatment in jails in Washington State and New Mexico. We have been informed that New Mexico implemented a program to treat its opioid addicted inmates with methadone as of November, 2005.

Hepatitis - C Training Project Hepatitis - C Training Project
AATOD has also made significant progress in training OTP personnel in more than 20 different cities in eight states throughout 2005 through
a SAMHSA/CSAT training grant, contracted with McKing Consulting. The training has been conducted by representatives of the Hepatitis-C Association. This new round of training brought the most current information about hepatitis-C into Alabama, Maryland, Michigan, Nevada, New Mexico, Ohio, South Carolina and Washington, DC, building on the success of AATOD’s previous pilot project.

HIV Project
AATOD used a grant from SAMHSA/CSAT to focus on the distribution of HIV Rapid Test Kits to methadone treatment programs in Florida, New York, Delaware and Maryland. While SAMHSA/CSAT distributed approximately 200,000 of these test kits to methadone treatment programs throughout the country, AATOD focused on the use of such test kits in OTPs in these four (4) states.

Publications and Policy Initiatives
AATOD continued to work with federal agencies on a number of policy initiatives, including the publication of the SAMHSA/CSAT Treatment
Improvement Protocol 43, Medication-Assisted Treatment for Opioid Addiction and Opioid Treatment Programs.After three years of work and coordination, SAMHSA/CSAT officially released this massive document to the country on October 25, 2005.

The publication of this valuable resource will support the ongoing accreditation-related work as treatment programs improve their delivery of clinical services throughout the United States.

The AATOD Board of Directors also finalized two critical policy statements during 2005. The first was approved during March, 2005, reinforcing AATOD’s previously published positions with regard to OBOT and how methadone treatment should be used as we expand access to medical maintenance treatment for people who are stable in the OTP setting, responding to ASAM’s OBOT policy statement of July 27, 2004.

After months of careful deliberation, the AATOD Board also promulgated recommendations to the field for guest medication, encouraging treatment programs to use standardized interfacility referral instruments, improving the flow of information from one facility to the next so that patients would have an easier time in arranging for guest medication travel.

Media Training Project for OTP Managers
AATOD initiated a media training project during 2005, which has been targeted to train OTP managers in communicating with the media. Ms.
Colleen O’Connor and Mr. Frank Carillo of Executive Communications Group met with AATOD member providers in New York, Missouri and Nevada to develop a unified message to positively influence the public perception of our work. This has been supported by Vista Pharm, Inc. and will culminate in a pre-Conference session on April 23, 2006 just prior to AATOD’s Conference in Atlanta. This pre-Conference session will roll-out three key messages, which are specifically designed to counter the stigma and stereotypes most frequently associated with medication assisted treatment.

Collaboration With Our European Associates
One of AATOD’s most far-reaching initiatives in 2005 has been working with our European counterpart European Opiate Addiction Treatment Association (EUROPAD) in increasing access to methadone treatment in different parts of the world.

We have been working with Dr. Icro Maremmani (President EUROPAD), and his associates in addition to Russian officials as a means of providing access to methadone and buprenorphine treatment to Russian citizens in need of such care. We have worked throughout 2005 in establishing the basis for a major conference to convene in Moscow, during March 29 - March 31, 2006, which will address this extremely critical health matter. The proposed title of the conference is Health of the Nation Fighting Narco- Terrorism.This Conference represents the beginning of a progressive multi-year international cooperation, involving our associates in other countries, U.S. federal agencies, agencies through the Russian Federation and other capitals of the world. It promises to have a major impact in responding to the needs of heroin-addicted individuals throughout the Russian Federation, having a significant impact in decreasing narcoterrorism and disrupting the channels of illicit heroin sales.

Conclusion
AATOD’s staff has worked with Board Members, treatment providers, federal and state agency officials, patient advocacy groups, related corporate interests and the media to expand knowledge of methadone treatment throughout the United States and abroad in addition to fulfilling the primary goal of our Association, Expanding Access to Quality Addiction Treatment Services.

All of these initiatives, which have been outlined in this report, will be prominently featured during the Association’s next National Conference of April 22 - 26, 2006 in Atlanta, Georgia.

We are extremely grateful to have had the support of so many gifted people and organizations throughout the year as we have fulfilled an ambitious agenda, connecting our past accomplishments to a meaningful future for patients in the treatment system.