A new program that's a part of Gov. Greg Gianforte's approach to addressing substance use disorder in Montana will begin with six providers using a new method for treating addiction to methamphetamine and other stimulants.
The program is starting with $1 million in federal grant money and the state health department is seeking approval of a waiver from the federal government to cover the practice going forward, which would expand its availability.
The program is called TRUST, for TReatment of Users of STimulants. In an emailed statement, Gianforte said he expects the project to help people through recovery.
“The impact that meth and other stimulants have in Montana is immense,” Gianforte said. “The drug crisis we face is ripping apart our families and devastating our communities. It’s critical we invest in treatment to effectively address the impact of these toxic substances on the brain and to support patients in their long-term recovery from this chronic illness."
Earlier this year Gianforte advocated for his Healing and Ending Addiction through Recovery and Treatment (HEART) Initiative. The Legislature dedicated about $6 million, which will draw down additional federal money of roughly $23 million total, to the program when it crafted a bill implementing legal marijuana earlier this year.
The providers include two state-approved substance use disorder treatment providers, three federally qualified health centers and a hospital. The providers include Benefis Health System in Great Falls, Alternatives, Inc. in Billings, Rimrock Foundation in Billings, Bullhook Community Health Center in Havre, Southwest Montana Community Health Center in Butte, and Alluvion Health in Great Falls. They could serve up to 420 people over the next two years.
The TRUST program includes a 12-week intensive intervention phase, followed by up to nine months of recovery support. It includes approaches such as contingency management, which is small, non-monetary rewards for positive actions. It also involves cognitive behavioral therapy, community reinforcement approach, motivational interviewing, physical exercise, and self-help mutual support.
Zoe Barnard, administrator of the Addictive & Mental Disorders Division, said in an interview this week the TRUST program uses some of the first evidence-based approaches to treating stimulant use disorders.
"Components of TRUST are mostly things that providers are trained to use for substance use disorder treatment, but it's the way that those components are put together that makes the TRUST model so effective," Barnard said.
The continued support can include things from helping people with relationship issues, entering the workforce and securing housing, Barnard added.
"A lot of those activities may need to continue post the 12-week period," Barnard said.
Deaths, hospitalizations and emergency department visits tied to meth abuse have risen over the last few years in Montana, and more than 65% of cases where a child is removed from their home because of abuse or neglect involve meth as the primary drug used. The state health department estimated approximately 79,000 Montanans have a substance use disorder.
"In the western U.S. and Montana, the meth problem is arguably a bigger problem than opiate use disorder," Barnard said.
The work that has been done on stimulant use disorder treatment has accelerated in the last five to 10 years, Barnard said, leading to evidence-based treatment that's the framework for programs like TRUST.