The purpose of the Missouri State Opioid Response 2.0 (SOR 2.0) project is to build upon the system changes for Opioid Use Disorder (OUD) prevention, treatment, and recovery that have been activated by Missouri's State Targeted Response (STR) grant and first SOR grant, while adding a focus on stimulant use and adding critical initiatives. Upstream prevention approaches targeting substance misuse in high-risk youth and clinical decision making among medical providers will be key grant components. Overdose prevention and response strategies will be expanded to better reach active drug users through various efforts, including telemedicine visits, street outreach programs, and partnerships with a community-based anti-violence program. Through the continued and honed implementation of Missouri's "Medication First" treatment approach for OUD as well as Contingency Management for stimulant use, we aim to increase access to evidence-based treatment and improve transitions of care. By expanding peer-led recovery training, we aim to better prepare individuals with lived experience to deliver valuable clinical support services. To enhance the sustainability of project accomplishments, administration and evaluation teams will strengthen existing collaborations, help enact key system sustainability changes, and demonstrate the effectiveness of protocols implemented through the award.
Missouri's primary focus will be increasing access to treatment for OUD and providing evidence-based services to individuals with presenting for care within state-funded programs, hospitals, and the St. Louis County Jail, the largest county jail in Missouri. Primary prevention activities will center on increased awareness of prescription drug misuse and healthy coping skills led by the Boys & Girls of America, Big Brothers Big Sisters, and local agencies in high-risk areas. Overdose prevention and naloxone training efforts will target active drug users and homeless individuals through street outreach programming and training social services staff. Grant partners will provide telemedicine and consultation to providers treating pain and OUD, and statewide telemedicine infrastructure for OUD treatement delivery will be further enhanced and include protocols for post-overdose buprenorphine inductions. Holistic recovery support services will be provided through Recovery Community Centers and Recovery Support Services, particularly housing, employment assistance, and family support, delivered with a focus on peer engagement and modification-friendly principles. The State of Missouri Department of Mental Health (DMH) will lead the project, with administration, implementation, and evaluation activities performed by the University of Missouri, St. Louis (UMSL) - Missouri Institute of Mental Health (MIMH). Missouri's SOR 2.0 project will further transform the system of care for OUD by implementing evidence-based protocols demonstrated to save lives, offering extensive multimodal professional training and consultation, and delivering effective and compassionate services to individuals across healthcare settings throughout the state.