2023 Year in Review
By Lucy Connery, MPH
Medication for Addiction Treatment and Electronic Referrals (MATTERS) was developed in 2016 to respond to the growing opioid crisis in New York State (NYS) and across the United States. Each year, the MATTERS team develops an annual Year in Review report to share data and outcomes with network partners and stakeholders. 2023 marked a year of growth and continued development of the MATTERS program, launching new harm reduction services, further expanding access to treatment across NYS, and laying the foundation for expansion into Pennsylvania and New Jersey.
Referral Network
MATTERS facilitates rapid referrals for individuals with opioid use disorder (OUD) and substance use disorder (SUD) to outpatient medication for addiction treatment. Emergency departments, inpatient units, first responders, law enforcement, drug courts, telemedicine agencies, and community-based organizations submit referrals, linking individuals with OUD and SUD to an outpatient treatment organization of their choice for follow-up. MATTERS’ outreach team successfully onboarded 130+ new network partners to the referral platform in 2023; Figure 1 highlights details of onboarded partners.
Participating Organizations
2022
2023
Hospitals
75
85
Treatment Organizations
191
239
Miscellaneous Referring Sites*
91
148
Peer Organizations
9
14
Private Pharmacies
53
62
Figure 1: Network Partner Growth
*Law enforcement, correctional facilities, educational settings, first responders, telemedicine, etc.
MATTERS partners with 210+ unique referring sites, 250+ receiving treatment organizations, and 1,000+ private and chain pharmacies across NYS. Individuals referred through MATTERS can choose from over 2,200 weekly appointment slots available through the platform and can be seen as soon as the next day for treatment.
Rapid Referrals
In 2023, there were over 1,300 referrals submitted through the MATTERS platform which reflects a near 30% increase from the number of referrals in 2022. Referrals are completed in 3-5 minutes and connect individuals to several resources, including the MATTERS medication and transportation vouchers. Individuals referred through MATTERS are offered a transportation voucher to cover the cost of a ride to and from their first clinic appointment. MATTERS’ medication voucher covers the cost of up to 14 days of a buprenorphine prescription for individuals with Medicaid or no insurance.
According to the United States Census Bureau, nearly 27% of the U.S. has Medicaid or no insurance (2023); in 2023, over 90% of all individuals referred through the MATTERS platform were offered the medication voucher, which indicates the importance of this service. MATTERS’ suggested protocol calls for a two-week bridge prescription of buprenorphine to ensure patients do not experience a lapse in their treatment. Of the 90% of individuals who received the medication voucher, about 83% of patients received a buprenorphine prescription at the time of referral.
Of the over 1,300 total referrals in 2023, approximately 55% came from telemedicine settings. Telemedicine services further reduce barriers to medication and treatment for individuals facing significant transportation issues. MATTERS partners with UBMD Emergency Medicine to offer telemedicine evaluations for OUD across New York State. Individuals can connect to these telemedicine services to receive an assessment for OUD, medication prescription as applicable, and referral to outpatient treatment. Additionally, MATTERS partners with virtual treatment organizations to accept referrals for follow-up.
Each month, MATTERS telemedicine services complete an average of 185 OUD-related calls, saving individuals hundreds of dollars in health care costs associated with traditional emergency department visits. Figure 2 outlines telemedicine utilization throughout 2023.
Figure 2: Telemedicine Utilization
MATTERS has made great progress in expanding into law enforcement and correctional referrals, helping link individuals to the treatment they need after being released from jails or the court systems. In 2023, there was a 10-fold increase in the number of referrals that came from correctional settings. This linkage to treatment from criminal justice settings is vital to reducing recidivism in drug-related crimes (Belenko, Hiller & Hamilton, 2013).
Harm Reduction
Throughout the course of 2023, MATTERS saw rapid expansion in harm reduction, launching two new services: harm reduction vending machines and trainings. All MATTERS staff are trained and certified to lead Opioid Overdose Response Trainings in the community; these trainings educate on the signs and symptoms of an opioid overdose and how to administer naloxone (commonly referred to as Narcan). Additional trainings include how to use fentanyl and xylazine test strips as well as a general harm reduction educational training. In 2023, MATTERS led 55+ harm reduction training sessions across New York State. As a result of these trainings, over 850 first responders were trained on naloxone administration and provided with Narcan. Over 4,200 doses of naloxone were distributed through these trainings, community outreach activities, and harm reduction vending machines.
MATTERS successfully deployed and activated nine harm reduction vending machines in 2023 and continues to introduce new machines into communities across NYS. These vending machines are available 24/7, 365 days a year, and provide free supplies such as fentanyl test strips, xylazine test strips, and naloxone. Figures 3 and 4 show images of the MATTERS vending machines and the current map of live vending machines across NYS, respectively.
Figure 3: Vending Machine Picture
Figure 4: Vending Machine Map
In addition to its success in distributing naloxone and deploying harm reduction vending machines across NYS, MATTERS has demonstrated remarkable progress in the distribution of fentanyl and xylazine test strips. MATTERS distributes free fentanyl and xylazine test strips to individuals and organizations across NYS via direct mail. This service launched in August 2022 and began distributing xylazine test strips in May 2023 in response to the growing statewide and national concerns about xylazine exposure. This test strip distribution program has had great success this past year; MATTERS distributed over 6.7 MILLION fentanyl and xylazine test strips in 2023! Between October and December 2023 alone, MATTERS’ team shipped over 4 million test strips into the community, as seen in Figure 5. This extensive test strip distribution service reaches all 10 regions in NYS, as seen in Figure 6.
Figure 5: Test Strip Distribution by Month
Figure 6: Test Strip Distribution by Region
Moving into 2024
The MATTERS program is constantly evolving to better meet the needs of individuals with SUD. Many individuals with OUD may experience mental health concerns or engage in polysubstance use (Compton, Valentino & DuPont, 2021). To better serve these populations, MATTERS’ referral platform is working to expand to offer referrals for other SUD, including alcohol use disorder and stimulant use disorder, and mental health conditions. In 2024 MATTERS will develop a new iteration of the secure referral platform. The platform will allow for more sophisticated patient tracking, integrated telemedicine evaluations, reengagement and relinkage for patients unable to attend their first appointment, along with inter-state referrals. This integration of other forms of SUD into the MATTERS referral platform will improve efficiency and effectiveness of referrals and will improve patient outcomes. In addition to expanding its services for SUD, MATTERS continues to grow geographically.
In 2024, the MATTERS platform will expand into New Jersey and Pennsylvania to improve access to treatment for SUD. This expansion will offer flexibility to individuals who work and live across state lines in choosing which location they prefer to follow up for treatment. This effort further supports MATTERS’ mission in providing every person living with substance use and mental health disorders multiple pathways to treatment and resources within their own communities. Figures 7 and 8 feature representatives from the MATTERS team visiting our partners in Pennsylvania and New Jersey respectively.
Figure 7: MATTERS in Pennsylvania
