In addition to being a trusted addiction treatment services provider, Fall River-based Stanley Street Treatment and Resources Inc. ( SSTAR ) has been engaging in addiction research projects for many years and is now helping to vet the next generation of medication-assisted treatment (MAT). SSTAR is investigating the safety and efficacy of injectable buprenorphine. This medication could potentially eliminate the need for daily visits to the clinic to receive doses. Patients who are eligible to participate in this pharmaceutical study will receive free buprenorphine treatment for up to 6 months and individualized weekly counseling. SSTAR’s Dr. Baily pointed out in a recent article that, “Access to cutting edge care through research is especially important to the uninsured and underinsured population by making access to treatment and medication easier and available at little to no cost to participants.”
Diminish the effects of physical dependence on opioids, such as withdrawal symptoms and cravings
Increase safety in cases of overdose
One manufacturer, Braeburn Pharmaceuticals and Camurus recently entered into Phase 2 of their study of CAM2038, weekly and monthly subcutaneous buprenorphine injections. Behshad Sheldon, President, and CEO, Braeburn Pharmaceuticals said, “Our goal is to provide a suite of best-in-class, long-acting treatment options tailored to the individual needs of patients suffering from opioid dependence and chronic pain.”
We’re proud to shine the spotlight on CODAC, providing opioid treatment as well as recovery and prevention resources to individuals, families, and communities. Recently, the state deemed CODAC as the first “Center of Excellence” regarding the treatment of opioid use disorders.
Rhode Island health officials estimate 20,000 Rhode Islanders are addicted to some form of opioid. However, only a few thousand are getting medication-assisted treatment. Given the number of people affected by addiction, there is a shortage of certified physicians. Currently, R.I. only has a total of 171 buprenorphine prescribers.
Increasing Opioid Treatment Access
Governor Raimondo advocates for the access of buprenorphine (Suboxone) and the availability of psychiatrists, social workers, and recovery coaches. “Rhode Island’s first Center of Excellence will make it easier for patients with opioid use disorders…,” offers Raimondo.
CODAC provides Methadone, Naltrexone, or Suboxone for patients coming into treatment, so physicians can work with patients to choose the best treatment option for each person. The Centers for Excellence model helps compensate for the shortage of certified professionals. Rebecca Boss, acting director of the Department of Behavioral Healthcare, Developmental Disabilities and Hospitals celebrates CODAC for “recognizing overdose as a public health crisis and moving swiftly to complete the application process.”
About 1,700 Rhode Islanders died of drug overdoses between 2006 and 2014. In 2014, Rhode Island had the sixth-highest rate of overdose deaths per 100,000 residents in the country. The US Centers for Disease Control blames a majority of drug deaths on prescription opioids and heroin.
Primary Care Providers Needed
Patients may walk into a Center of Excellence or be referred. From there, patients are stabilized, given treatment, and referred to a care provider in the community. Advocates hope the design will help primary care doctors treat a growing number of opioid-dependent or addicted people. Centers can cater to patients who may need initial intensive care but do not require in-patient care.
Rhode Island is not alone in battling citizen opioid addiction. Connecticut recently deployed a three-year plan to combat addiction based on Yale University research. In August alone, 27% of those admitted to the New Haven outpatient clinic were diagnosed with opioid-use disorder. As US Attorney, Peter Neronha recently pointed out, the numbers of those in need may be obscured. “Those potentially at risk of death were brought back by Narcan.” Naloxone stops the effects of heroin or opioid overdose, stripping the opiate receptor site, and restoring breathing. “When we realize how many times Narcan is being administered, we start to get a sense of how deadly this problem really is,” offers Neronha.
Since 1971, CODAC has served the Rhode Island community. Its five locations enable a range of outpatient recovery treatment and prevention services. Those struggling with drugs, gambling, or addictive behaviors rely on CODAC for compassionate and personalized service.
April 2016 – Evergreen Treatment Services (ETS) has offered medication-assisted treatment for adults with opioid use disorder since 1973. This August they plan to open their newest location, a 350 patient facility in Renton, King County, Washington. This new addition comes on the heels of a 58% increase in heroin related deaths in 2015.¹ Assistant Division Director of King County Behavioral Health and Recovery Division Brad Finegood noted that the opening of this clinic is a direct result of the overwhelming need for more treatment facilities in the area. “The problem is growing faster than our ability to build new facilities.”² ETS CEO, Molly Carney, said that methadone and buprenorphine as well as counseling services is a crucial part of treatment for those addicted to opioids.²
However, just offering this services does not solve the larger societal problem of public stigma. Time and time again we see instances of people fighting against the opening of clinics in their respective communities. Business owners and residents often feel concerned when they hear of the possibility of a medication-assisted treatment facility (often misleadingly referred to as just “methadone clinics”) opening near them for fear that an increase in criminal activity will follow. In a Philadelphia Daily News report on a proposed clinic opening they quoted one resident as saying, “We’re not gonna tolerate the existence of this establishment…No community is an appropriate place for a methadone clinic.” The sentiment “not in my back yard” is commonly applied to treatment clinic openings. Logically, it should instead be applied to addressing overdose deaths because those are happening in everyone’s backyard. This is just one of the barriers that advocates, professionals and those in recovery face.
In a powerful statement, Assistant Division Director of King County Behavioral Health and Recovery Division, Brad Finegood said, “Public support is going to be very important…One of the biggest battles we are fighting is stigma. People who are opiate dependent are not bad people, they are people who have a sickness and illness. They have a medical condition. Rather than people being afraid, we need the community to rally around the fact that people need treatment. We have a need in our suburban cities and rather than saying we don’t want the services here, we want communities to embrace treatment and treatment that we know it works.”² Shilo Murphy of the People’s Harm Reduction Alliance says that, “If you want to stop overdose deaths…the key is getting rid of the stigma, loving and respecting people who use, supporting them to use with friends, providing them with education, and not shunning them.”¹
APT Foundation, a leading provider of substance use disorder, drug, alcohol, mental health, and medication-assisted treatment services in Connecticut, was recently interviewed by News Channel 8 (WTNH) about the efficacy of medication-assisted treatment for opioid addiction.¹
When combined with a comprehensive treatment plan, addiction treatment using methadone has proven to help people reduce or quit their use of heroin or other opiates..² APT treats 4500 patients using methadone and 700 patients using buprenorphine. For methadone treatment, they require a minimum of 3 years of treatment with the goal of keeping patients engaged in their own recovery. According to Jacquie Slater, WTNH Reporter, APT said, “addicts who do not use a supervised medication program like methadone to get clean have an 80 to 90 percent chance of relapsing in the first year.”
This article also indicated that 44% of 700 overdose deaths in the State of Connecticut were tied to individuals who were previously incarcerated. “When you combine that statistic with the fact that an inmate’s tolerance for drugs goes down while incarcerated, the result is an increased risk of overdose once they are released.”¹ Government officials have noted the success of prisoner methadone treatment programs already in place and are hoping to expand these types of programs. Dr. Kathleen Maurer, Medical Director for the Connecticut Department of Correction said the goal is to treat 1,000 prisoners a year at an estimated cost of $4 million.³
The Associated Press interviewed Connecticut-based treatment provider, Recovery Networks of Programs, Inc., who has been working directly within the jail system to provide methadone treatment for prisoners suffering from the disease of addiction. CEO John Hamilton said, “It’s the right thing to do…It’s inhumane to have someone go through withdrawal. We don’t want to see those clients suffering.” Prisoner patients also shared that their withdrawal experiences in prison often lead to their hospitalization. One such incarcerated patient said, “It was a real blessing to get back in the program and maintain my sobriety.”³