In my senior year of college, I had the opportunity to shadow a substance abuse counselor leading a weekly court-mandated substance abuse group. The primary focus of the group was to educate members about the harm of addiction. After shadowing the six-week program I left with more knowledge about addiction than ever before, but I felt like there was something missing in the group. While the group provided information about addiction, it focused solely on one aspect: that addiction was an act of choice. For a court-mandated group, this may have been appropriate. However, through my service year as a Patient Advocate in the Prescription Assistance Program and Medication Assisted Therapy (MAT) program I have learned that addiction is much less black and white. For many people who use drugs, what may have started as a choice evolved into a form of survival.
The MAT program at Health Center 6 works to address Opioid Use Disorder (OUD) from a holistic approach, understanding that many factors such as mental health, past and current trauma, access to recovery resources, social support, and geographical location must be considered in a patient’s treatment. Patients diagnosed with OUD receive treatment using a holistic model that combines behavioral health counseling and medical care, all within a primary care setting. The use of Suboxone, a medication that comes in a film or tablet, subsides withdrawal symptoms and blocks the opioid receptors in the brain. This, in turn, can decrease cravings and allow the patient to focus on recovery. For many patients, this approach is appealing, as it allows patients to take the Suboxone at home and attend appointments on a weekly to monthly basis. Other MAT programs, like Methadone clinics, require patients to attend the clinic daily to receive medication under supervision.
While there are many benefits to MAT, there are still barriers to healthcare such as access to transportation, low income, citizenship status and access to insurance coverage for the medication. Through my role in the MAT program, I work to connect patients with outside services by building relationships with other organizations to address these barriers. They say raising a child takes a village, and I believe the same concept can be applied to the opioid epidemic. To truly provide the best care for a patient, a group effort is required. One organization cannot provide every service possible.
One way I have fostered outside relationships is by establishing the patient transportation system in the health center with the Temple TRUST (Temple Recovery Using Scientific Treatments) Clinic, part of the Temple Healthcare System. Using a Hub and Spokes care model, the Temple TRUST Clinic acts as a “hub” and provides a multitude of inpatient and outpatient services for OUD as well as funds needed services and referral partnerships with other community organizations (“spokes”) such as Health Center 6. Through this collaborative effort between the “hub and spokes,” we are able to provide services that meet the specific needs of our patients ranging from applying for housing to insurance and transportation.
Lack of access to transportation is one major reason patients miss their appointments in Health Center 6. Through Temple TRUST, we were able to set up a transportation system, Circulation, that functions as a medical “Lyft” service for patients in need. In my “behind the scenes” role I often do not get to interact with MAT patients face to face. However, by scheduling daily rides for two patients in particular, I was able to learn more about their story and develop a relationship that allowed me to see the patient as a person before the diagnosis of OUD. In contrast, by establishing relationships with other community organizations, I now see the need for holistically approaching the opioid crisis as a collaborative team with a willingness to listen and a non-judgemental attitude. By addressing the health barriers together, we as healthcare professionals and as a community can give our patients, family members, friends, and neighbors an equal opportunity for recovery.