AIDS Drug Assistance Programs’ (ADAPs) Support of Substance Use Treatment for the Clients They Serve

By Amanda Bowes July 5, 2016

Today, NASTAD (the National Alliance of State and Territorial AIDS Directors) released a Fact Sheet on ADAP Formulary Coverage of Substance Use Treatment.  The fact sheet outlines how AIDS Drug Assistance Programs (ADAPs) can support substance use treatment medications and related services for the clients they serve.  It also provides drug-specific information for medications that are most frequently used as part of substance use treatment.

Substance use disproportionately impacts people living with HIV (PLWH), posing challenges in terms of the overall effectiveness of HIV care and treatment and their broader health.  In addition to deleterious effects on HIV-specific health outcomes, they must also contend with risks of overdose and death from overdose, a common cause of non-AIDS-related death among PLWH.  Yet individuals with substance use disorders may not seek treatment for these issues because of inadequate screening, stigma, or a lack of available and adequate services.

When used in combination with behavioral therapy, substance use treatment medications allow individuals to manage addiction or dependency by reducing their risk for overdose, cravings, and/or symptoms of withdrawal.  For PLWH who use substances, these treatments bolster multiple “bars” within the HIV care continuum, including adherence to ARV treatment and viral load suppression.  They fall into the following categories: (1) overdose prevention; and/or (2) medication assisted treatment (MAT).

Beyond the provision of ARVs, ADAPs play a critical role in supporting the availability of medications for many co-morbid conditions PLWH may be impacted by, including substance use treatment medications.  As of December 31, 2015, 14 ADAPs cover one or more FDA-approved substance use treatment medication on their formulary.  ADAPs cannot, in isolation, cover or pay for the full breadth of costs associated with these vital medications, however.  As detailed in Health Resources and Services Administration’s (HRSA) Policy Notice 10-02, outpatient and residential substance use treatment are considered a core medical and supportive service, respectively, under the Ryan White HIV/AIDS Program.  ADAPs should work in concert with other entities, including Ryan White Part B services, to ensure comprehensive access to substance use treatment medications and related services for their clients who need them.

Learn more about ADAP here.