Medication First aPPROACH

The Missouri Department of Mental Health and Opioid STR/SOR grant partners have developed and disseminated a “Medication First” treatment approach to OUD, analogous to the Housing First approach to chronic homelessness, across dozens of Missouri’s state-funded substance use disorder treatment programs.

Key principles of Medication First:

  1. People with OUD receive pharmacotherapy treatment as quickly as possible, prior to lengthy assessments or treatments planning sessions;

  2. Maintenance pharmacotherapy is delivered without arbitrary tapering or time limits;

  3. Individualized psychosocial services are continually offered but not required as a condition of pharmacotherapy;

  4. Pharmacotherapy is discontinued only if it is worsening the person’s condition.

What’s happened so far….

  • STR/SOR funding has been provided to 69 treatment sites (see map below) that are committed to implementing OUD treatment consistent with the Medication First principles

  • Over 5450 people have received treatment

  • Outcomes are promising; people enrolled in STR/SOR Medication First treatment programs have an increased likelihood of :

    • Receiving an evidence-based medication for the treatment of OUD

    • Receiving that medication sooner

    • Being retained in treatment at 1, 3, 6, and 9 months

    • Costing the State less in reimbursed services on average, per month

  • To learn more about Medication First and treatment implementation and evaluation , visit the Findings page


Looking for additional Medication first implementation resources? click the links below.