Alaska
The two OMT programs in Alaska are separated by 350 miles and many community differences. Fairbanks is less than 1/3 the size of Anchorage. Our weather is more extreme. Very few people "end up" in Fairbanks - you really have to decide to come here. We currently have 26 patients enrolled and have no waiting list. We encounter difficulties accessing mental health services for our patients. We have to pay private providers for evaluations and the wait can be 4-6 weeks. We are a non-profit clinic and struggle with finances - as many clinics do. Anchorage has much more demand for treatment than we do in Fairbanks, so we don't complain too much.

Colorado
COTOD (Colorado Organization for the Treatment of Opioid Dependence)

We are now in our third year as an official state association, though all
Colorado Opioid Replacement Therapy programs have been meeting as a group with the state methadone authority for over 20 years. As a provider group we are proud of our excellent relationship with our Single State Agency and Methadone Authority. This has been a long-standing productive partnership

We recently Elected new officers:

• Chairperson: Pam Manuele

• Treasurer: John Lundin-Martinez (re-elected)

• Secretary: Tina Beckley (re-elected)

• Chairperson Elect: Marc Liebert

• AATOD Board Delegate: Eric Ennis (re-elected)

We currently have several programs that are dosing methadone in Colorado jails. The jails involved include Denver County, Boulder County, Aurora Municipal, and Pueblo County. At present, the programs involved must deliver methadone to the jails. In Denver County, the Denver Health OTP delivers on a weekly basis, and the methadone is stored and dispensed by the Denver Health nurses employed onsite at the county jail.

START Protocol

The Addiction Research and Treatment Services (ARTS) and Denver Health have been selected to participate in the "START" protocol. This study is a cooperative effort of the National Institute on Drug Abuse (NIDA), the Veterans Affairs Cooperative Studies Program Coordinating Center Perry Point (VACSP), the NIDAS Clinical Trials Network and Reckitt-Benckiser Pharmaceuticals. The purpose of the study is to compare the effect of buprenorphine/naloxone and methadone on liver function in the outpatient setting.

Connecticut
Connecticut was awarded 7.5 M per 3 years of Access To Recovery (ATR) money. Methadone treatment is included in the panel of reimbursable services.

Connecticut Counseling Centers and Hartford Dispensary have been chosen as 2 of only 10 narcotic treatment programs to participate in the START Study (Starting Treatment with Agonist Replacement Therapies). This study will randomize 600 patients to either buprenorphine or methadone and up to 1000 patients may be enrolled to achieve the 600 study completers.

The primary objective is to compare the effects of suboxone and methadone on liver functions. Rico Bilangi and Paul McLaughlin are on the Protocol Executive Committee.

Florida
In May 2002, the Center for Drug Free Living and the Orange County Jail began providing methadone dosing for inmates affiliated with local treatment programs. Although, this approach met the needs of inmates already linked to treatment; inmates with opiate addiction who were not affiliated with local programs were being treated with a standard opiate withdrawal protocol. In December 2004, two physicians with the jail became Buprenorphine certified and it is anticipated that in March 2005, the Orange County jail will begin treating opiate dependent clients with a Buprenorphine protocol developed by the Center for Drug Free Living's medical director. The Center participated in the CTN for Buprenorphine and has been using Buprenorphine in their Opioid Dependency Treatment Program, Inpatient Detox, and Outpatient Detox for some time. Further, the jail and the Center are developing a plan to transition inmates to local programs upon release. This should enhance services within the corrections community for opiate dependent inmates.

Name Change
The Board of Directors for the Illinois Methadone Treatment Association has voted to formally change its name to The Illinois Association for Medication Assisted Addiction Treatment. This revision acknowledges the advancement in medication therapies and is made in anticipation of future pharmacological developments. As a result of the name change and the accompanying change in philosophy, IAMAAT is undergoing a change in its by-laws. It is expected that the executive committee will be ready to present the new by-laws for a vote in February.

Certification for Medication Assisted Therapies
IAMAAT is convening a task force to develop an enhanced certification for substance abuse counselors in Illinois. This enhancement would require certified counselors to complete addictional training and demonstrated knowledge in medication assisted therapies. The planning process is expected to be completed by July 2006.

Minnesota
We currently have six outpatient maintenance programs and two residential programs using methadone as a withdrawal medication. Last year, we issued an RFP and funded three proposals for methadone program expansion to three different sites. One of these is a Mobile Methadone Unit attached to an existing program which is enjoying success. Minnesota established a Central Registry per 42 CFR 2.34 effective 1.1.05.

New Mexico
A methadone maintenance program is now housed in the Public Health Clinic at the Metropolitan Detention Center in Albuquerque. The clinic is managed by CRC Health Corporation for the Behavioral Health Services Division of the Department of Health. Inmates are screened upon admission and, if currently enrolled in a clinic, may voluntarily receive services. Pregnant women will automatically receive services, which include medical monitoring, dosing and counseling. Upon release, inmates are referred back to their home clinic. There is a detox protocol for inmates sentenced to a Corrections facility. The project includes an evaluation component provided though a Robert Wood Johnson Grant. We may to go to Phase 2 within two years. Phase 2 will offer treatment to inmates who are opioid dependent and wish to begin an opioid replacement program with either methadone or buprenorphine.

Two new sites have recently been approved. The Veterans Hospital in Portland now offers methadone treatment enabling veterans to obtain services at a VA facility. The second site to become approved is located in Ontario, Oregon. Ontario is located 45 minutes west of Boise, Idaho. The owners of the clinic are working with the State of Idaho in an effort to provide services to Idaho residents who receive Medicaid benefits.

Submitted by Jim Bradshaw, Regional Coordinator
Office of Mental Health and Addiction Services.
500 Summer St. NE E-86
Salem, OR 97301-1118
(503) 945-5814.

President - Richard Froncillo

Vice President - Glen Cooper

Treasurer - Robert Holmes

Secretary - Kristina DelPrincipe.

PATOD would like to thank Glen Cooper for all of his hard work as President of PATOD.

Rhode Island
Recent Developments from Rhode Island are as follows:

1. All Association member programs are CARF accredited for three (3 )
years.
2. CODAC Behavioral Healthcare renews contract for continuing opioid
treatment at the Department of Corrections.
3. Center for Behavioral Health Rhode Island held a fundraiser for infants and children with the HIV virus. It was organized by Center for Behavioral Health staff members and patients involved in advanced recovery group.
4. MARCAP - Medication Assisted Recovery and Advocacy Project is becoming more active.
5. CODAC Behavioral Healthcare will be participating in a SAMHSA/CSAT sponsored pilot program to provide Twinrix vaccine to patients in treatment.
6. Mike Rizzi has been reelected Chair of the Opioid Treatment Association of Rhode Island (OTARI) and will continue to serve as delegate to the AATOD Board of Directors.
7. CODAC opened a fourth OTP in Wakefield, RI with the support and
approval of local police and town council.

Washington
State Funded Buprenorphine by Deb Cummins, Division of Alcohol & Substance Abuse
Washington State Department of Social and Health Services (DSHS) added Buprenorphine to the list of Medicaid reimbursed medications on September 22, 2003. The DSHS Division of Alcohol and Substance Abuse (DASA) in conjunction with the DSHS Medical Assistance Administration (MAA) published the limitations and protocol in their Prescription Drug Program's Expedited Prior Authorization List. Medicaid funded recipients are required to meet an eligibility criterion, which includes participation in a state certified chemical dependency treatment program in order to access reimbursement. The criterion is designed to address short-term stabilization for clients with mild dependency and a six-month limitation was placed on Medicaid prescriptions. Clients in need of longer-term maintenance are referred to an opiate treatment program.

Since the introduction of the protocol in Washington State, the six-month payment limitation has become a topic of discussion among health care providers that have witnessed substantial benefits with clients who are dually diagnosed in terms of increased treatment program participation, abstinence, and reduced emergency room costs. DASA and MAA are conducting discussions about a possible exemption to the criteria for this special population that may extend the length of time the medication may be prescribed.

Jail-based Opioid Substitution Treatment in Seattle-King County, Washington by Mark Alstead, Seattle-King County Public Health, Jail Health Services
A new evidence-based opioid-substitution treatment program is being developed and implemented for the two jails in King County, Washington. The King County Council funded the Jail-based Opioid-Dependency Engagement & Treatment Program (JODET)), as an effort to: 1) reduce recidivism to drug use and criminal activity among those dependent on opioids; 2) increase access to treatment for those involved with the criminal justice system; and 3) reduce the spread of infectious diseases such as HIV, other sexually transmitted diseases, and viral hepatitis.

Phase 1 of JODET was implemented in May 2004, and involves careful assessment and documentation of opioid-dependence, provision of methadone treatment vouchers for use once the recipient has left jail, and intensive discharge planning and case management. During Phase 2, JODET staff members are applying for licensure and certification as an opioid treatment facility. Phase 3 is anticipated to begin the second quarter of 2005. Opioid-dependent inmates of the King County Correctional Facility in Seattle, Washington, and the Regional Justice Center in Kent, Washington, will be provided opioid treatment while in custody, including dosing with methadone.

West Virginia
It has been a very important year in West Virginia regarding methadone treatment.

	A moratorium is currently in place. There are no new methadone licenses or Certificate of Need being given until regulations are established for the State.
	An advisory group was formed to add input in formulating regulations. A final draft of the regulations are currently being presented for approval.
	The methadone providers in the state have concerns that the regulations are over restrictive and could lead to raising of the price for treatment as well as decreased client contact due to increased documentation.
	Regulations are expected to be in place by April which will end the moratorium on opening methadone programs in the state of West Virginia.
	In addition, We are working on building rapport with local hospitals , OBGYN's and pediatricians in the Eastern Panhandle to ensure fair and adequate care for pregnant women and their children.