Meredith Holt / Summit Community Care Clinic
Opioid addiction is the great current American public health crisis of our time.
As part of a nationwide push to get the right treatment options in the hands of frontline health workers, Summit Community Care Clinic has received the tools and training they need to launch a medicine-assisted treatment program, which uses medication during opiate withdrawal therapy to wean recovering users off of the powerfully addictive painkillers.
According to government estimates, a record 72,000 Americans died in 2017 alone from overdoses, with two-thirds of those overdoses blamed on opiates. Colorado also hit a record in 2017 with over 1,000 opiate deaths.
Through a federal program which waives strict requirements for opiate withdrawal drug prescription, paired with a state program that provides the required training to prescribe and treat patients with opiate-use disorders, the Care Clinic is one of a few facilities in the High Country armed to fight the opiate epidemic in Summit. The clinic’s MAT program went live on March 25, and has already inducted its first patient.
Dr. Kathleen Cowie, chief medical officer at the Summit Community Care Clinic, said that medicine-assisted treatment, while not a new treatment for opiate abuse, was unavailable to Summit patients in the past because of federal restrictions on prescribing Suboxone, which combines an opioid “agonist” and opioid antagonist Naloxone to resolve opiate withdrawal symptoms while preventing abuse of the drug itself.
“Previously, you needed to have a special license to prescribe Suboxone, mostly available at addiction recovery centers,” Cowie said. “But over the past couple of years with the opiate epidemic, there’s been a new push to allow primary care physicians, nurse practitioners and medical assistants to prescribe as well as to fill in that gap of all those folks who suffer from opiate-use disorder, but have no access to the required treatment.”
Given that community health centers like the clinic are often the first point of contact for people with opiate-use disorder, the feds see the health centers as the best place to start pushing MAT, paired with behavioral health treatment.
The Care Clinic was chosen to be one of the primary points of MAT access in Summit County, which has one of the higher per-capita opiate death rates in the state. All members of the clinic staff — from reception to medical staff, to prescribers and administration — underwent training to administer the program through a state initiative known as “IT MATTTRs 2” which aims to help health centers get the DEA waiver required to administer medicine-assisted treatment by providing the requisite training and skills.
“We provided training to the entire staff and to prescribers, and we’re tackling the problem using a team-based approach with a big emphasis on behavioral health,” Cowie said.
After clearing the initial intake, patients undergoing withdrawal symptoms will be guided through a regimented treatment aimed at eliminating those symptoms and curbing addiction cravings.
Patients must already have stopped taking opiates and be undergoing withdrawal as drugs like Suboxone are meant to stop addiction by eliminating withdrawal symptoms and weaning off the need for opiates. Patients who still use opiates while taking Suboxone are prone to addiction to the drug itself, as it induces a much lighter version of the same “high” derived from opiates.
Since opiate addiction is a complex medical condition that requires a multifaceted approach, Cowie recommended that people seeking treatment for their opiate addiction also transfer or establish primary care to the clinic, as specialists there are able to treat the disorder on several different levels aside from just the physical symptoms.
“To just treat addiction is insufficient, it requires a holistic approach,” Cowie said. “Treatment for addiction is hard; addiction is hard. Medicine-assisted treatment is just one tool to help folks overcome it, and that’s why we really think that the comprehensive integrated approach we practice is important, so people can turn their lives around now.”