Success stories in opioid addiction treatment in Northern Michigan.
Traverse Health Clinic, Traverse City
Courtney Whinnery, LPC, CAADC, Lead Substance Use Disorder Services Counselor
How long has the pilot program Opioid Health Home been in action at Traverse Health Clinic … and what are some of the most crucial ways your team supports the specific needs of your clients?
The official start date of the Opioid Health Home (OHH) was October 1, 2018. We have six providers who are able to prescribe medications (Naltrexone or Buprenorphine/Naloxone) to assist in patients’ recovery from opioid use disorder.
Our integrated or wrap-around approach means literally meeting the patients right where they are and surrounding them with the support they need to get healthy. We have primary care, counseling, and a peer recovery coach all in one spot—which decreases the patient’s need to coordinate transportation, childcare, time off work, etc. In addition to patient convenience, the collaboration that can happen in the moment has been amazing. As a mental health counselor, I don’t have medical expertise but I can peek out my office door and there are six providers and even more nurses who do. From on-the-spot blood pressure checks to questions about medication side effects, patients have been able to get immediate answers and solutions to their problems. And the flip side is also true—a patient in the clinic to see a primary care provider has access to counselors for those moments of panic, anxiety or depression.
What are some of the most effective tools to recovery?
Perhaps the most important link in our recovery program is the peer recovery coach. She is able to connect with patients on a level that puts them immediately at ease. She’s been through what they’re going through so they feel understood and often open up more freely about their needs. The peer recovery coach is able to then connect the patients to different resources that would help (bus passes, gas cards, peer support meeting suggestions, Hep C testing—the list goes on). She really has the opportunity to bridge the gap that so often exists. Patients are able to call/text or meet with her between office visits. She will often remind them of counseling appointments that would otherwise have been missed, or she helps to motivate them to keep appointments that they may have otherwise chosen to skip.
What message would you like to share, shedding light on efforts behind the scenes to help those with opioid use disorder?
We really can’t reiterate enough that people struggling with opioid addiction are just that—people. They are no different than you or me. They have a chronic illness and need help to recover from it just like we all do when we are sick. Instead of judging them, let’s embrace them, support them, love them and help them. Addiction is difficult enough to deal with, let’s not impose even more barriers for people to get help.
A common misconception is that using Medication Assisted Treatment (MAT) is trading one addiction for another. When the medications are used as prescribed, patients are not getting high and feeding their addictions. I’ve heard multiple patients use the same word to describe how the medications make them feel: normal. The cravings are reduced enough for patients to be able to focus on underlying issues, strengthening their recovery plans, repairing relationships, and working toward life goals. Essentially, MAT gives patients a chance at living instead of dying.
Bear River Health, Boyne Falls
Chris Frasz, Outreach Services Director
How does Bear River Health approach treatment for those with opioid use dependence?
Our clinical and medical teams receive continuous training to be up to date with new opioid and substance use treatment modalities—incorporating the latest education of effects of substances on the brain, the role of past trauma related to usage, and clinical treatments to support clients during and after their residential stay.
Bear River Health (BRH) provides a place of support and empathy for those struggling with any addiction, where clients receive a clinical treatment team made up of therapists, case managers, recovery techs and activity directors to get the best care while in treatment and a detailed aftercare plan to give direction to a client’s transition back to daily life. And to support the transition, BRH has recently opened an Outpatient Clinic, which provides a continuum of care through outpatient services consisting of individual and group sessions. Such counseling encourages continued growth and supports the direction that was initiated in residential care.
Bear River is currently applying for the participation with Opioid Health Home pilot program. It is initially being administered through the State of Michigan and the Northern Michigan Regional Entity, the local Prepaid Inpatient Health Plan for Medicaid funding of substance use disorder dollars. The Opioid Health Home program is a model of care that will coordinate the health and social needs of clients. The program will utilize a team of health care providers to provide full, wrap-around services. Programming will be designed to address substance use, mental health and other medical conditions that might not otherwise be addressed.
What role does the BRH campus and natural surroundings play in rehabilitation?
All clients have regularly scheduled opportunities to enjoy the Northern Michigan surroundings. Clients are connected to many of the beautiful areas of Boyne City, Walloon, Petoskey and Harbor Springs and can enjoy beach outings in the summer, ice skating in the winter, and walks through trails and parks throughout the year. Other activities have included disc golf outings, orchard visits, and potlucks and open talks with local AA and NA groups. The outings show new environments where clients can feel good, build on the connection with others, and engage in various activities that bring enjoyment without using any substances. Scheduled downtime on campus offers structured time to reflect or relax from the daily programming, off-campus groups, and outings.
Any treatment breakthroughs your staff notes as being especially effective?
Regular mindfulness courses by a specialized therapist also give an evidence-based tool to manage stress and understand the role of thought recognition related to actions and results.
Tell me a little bit about your aftercare model, and how it’s a meaningful part of reducing relapse in opioid addiction:
All clients leave BRH with an aftercare plan. The aftercare planning starts from day one. We touch on and make plans for every aspect of one’s life including employment, housing, community, sobriety, supports, mental health, physical health, etc. With a client-driven, well-balanced treatment, outpatient counseling maintains a connection to solidify new thinking and life patterns that have been learned.
Bear River Health has also initiated an Alumni Program to allow all graduated clients the ability to stay connected. A summer picnic had close to 100 attendees including clients, families, and members of the medical and clinical teams.
Northwest Michigan Health Services, Traverse City
Gwen Williams, Director of Programs
How has the approach to treatment evolved at your clinic in recent months?
Northwest Michigan Health Services in Traverse City has adopted a model of integrated medical and behavioral health care. This is provided under the umbrella of primary care services. We have begun offering Medication Assisted Treatment (MAT) using the medication Naloxone (Vivitrol), which reduces cravings and blocks the body’s ability to feel an effect from opioids. Primary care providers—nurse practitioners and physicians—oversee the administration of monthly injections at the health clinic. Our on-site behavioral health therapist also meets with patients in an integrated visit with medical providers, helping to coordinate and assure that the patient is receiving ongoing substance abuse treatment from outside agencies.
Any breakthroughs or treatments your medical professionals are seeing being especially effective?
The integrated approach of providing MAT and behavioral health care within the context of primary care, while connecting with substance use disorder treatment providers is a model that is proving to be successful. The more that primary care providers can be involved in helping to address the opioid crisis, the more successful we will be in treating it.
What about prevention efforts?
At Northwest Michigan Health Services, we partner with community organizations working on increasing involvement of family members dealing with substance use disorder, disseminating Narcan to reverse overdoses and offer families prescription lockboxes.
Are there specific ways you are able to help uninsured or underinsured people and families battling this addiction?
Northwest Michigan Health Services offers a sliding fee scale that sets fees for services based on family income and size that covers medical, dental and behavioral health care. The sliding fee scale program can also help those who have insurance but are struggling with high co-pays for care.