What is SAMAT?
Supportive Assistance with Medication for Addiction Treatment (SAMAT) is an Addiction Services program focused on preventing overdose, relapse, and recidivism for individuals with Opioid Use Disorder and/or Alcohol Use Disorder. Through the use of the SAMAT Protocol, FDA-approved medication is integrated with traditional treatment interventions for individuals who are both clinically and medically appropriate. Medication available through SAMAT currently includes injectable extended release naltrexone (Vivitrol®), and oral buprenorphine (Suboxone®) followed by injectable extended release buprenorphine (Sublocade®). SAMAT is available at all 14 state institutions and 20 county jails throughout the state.
Who is eligible?
In order to be an eligible candidate there are several criteria that an individual must meet to be deemed appropriate for SAMAT. Eligible candidates must:
- Be diagnosed with Opiate Use Disorder and/or Alcohol Use Disorder
- Have completed, or be currently assigned to, a Substance Abuse Program (SAP)
- Receive education regarding SAMAT procedures and available medications
- Have a verified release date within 60 days of beginning participation
- Be deemed clinically appropriate through a multi-step screening process
- Be deemed medically appropriate through both mental and physical health screenings
What medications are available?There are currently two types of medication for addiction treatment made available to eligible SAMAT candidates:
- Vivitrol®, which is a monthly injectable form of naltrexone. Vivitrol is FDA approved to help treat both Opioid Use Disorder and Alcohol Use Disorder. It is known as an antagonist as it binds to brain receptors without activating them, essentially blocking the effects of opiates and alcohol. It is not a controlled substance and there is no risk to overdose directly from the medication, however, there is risk of overdose if opiates are taken in an attempt to over-ride the receptor blocking function. Multiple studies have shown naltrexone to decrease or even eliminate cravings that can lead to relapse. Vivitrol® is recommended to be injected approximately every 28 days, and up to 2 injections are provided to SAMAT participants prior to release from incarceration. Upon entry into the community, a clinician will assist the participant in following up with a reputable medical provider to continue treatment.
- Suboxone®/Sublocade®, which are both forms of buprenorphine. Buprenorphine is FDA approved to help treat Opioid Use Disorder. It is known as a partial antagonist as it binds to and activates brain receptors which causes a ceiling effect and blocks the efficacy of other opiates. While it is a controlled substance, there is a reduced risk of overdose with buprenorphine compared to other opiates. Multiple studies have shown the effectiveness of buprenorphine and it has proven to keep individuals connected to treatment longer, allowing more positive outcomes. Suboxone® is an oral form of buprenorphine and is given to SAMAT participants while incarcerated in order to prepare them for Sublocade®, which is an extended release injectable form of buprenorphine. Participants will take Suboxone® for up to 60 days prior to release, at which time Sublocade® will be administered within 5 days of release from incarceration. Sublocade® is recommended to be injected approximately every 25-28 days. Upon entry into the community, a clinician will assist the participant in following up with a reputable medical provider to continue treatment.
Program fundingIn 2015, the Kentucky General Assembly, through SB 192, provided $3 million to the Kentucky Department of Corrections to provide Medication for Addiction Treatment (MAT) in conjunction with evidence based Substance Use Disorder treatment, utilizing naltrexone prior to release from incarceration. In 2019, the Department of Corrections received a grant through the Kentucky Opioid Response Effort (KORE) to expand Medication for Addiction Treatment (MAT) to include utilizing buprenorphine at select pilot locations. There is no cost to the SAMAT participant for these services during incarceration, and most insurance will cover the cost of treatment once the participant is released. Guidance for receiving and maintaining continued treatment is providing through a collaborative effort between Addiction Services, Probation and Parole, and Re-entry.
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