Developing a Coordinated Approach to a Drug Epidemic
In Maine, New Hampshire and across the country, individuals, families, communities and practitioners continue to fight the epidemic of opioid abuse and addiction. In Maine alone, 376 people lost their lives due to drug overdoses in 2016 — a 40 percent increase over 2015. Leveraging the strength of our healthcare system to develop a comprehensive and coordinated response, MaineHealth has spearheaded a number of evidence-based strategies to address this growing problem.
The MaineHealth Opioid Addiction Work Group was formed in 2016 to lead the development of a systemwide response to the urgent community need surrounding the opioid epidemic. The group includes leaders, clinicians and representatives from every MaineHealth member organization facing this issue. The plan integrates prevention, education and treatment through a collaboration between behavioral health, primary care and ob/gyn providers.
Hub-and-Spoke Treatment Model
This “hub and spoke” treatment model is led by Maine Behavioral Healthcare (MBH), which partners with primary care providers to provide a continuum of care to address this chronic illness while treating the whole patient with dignity and respect. The “hub” is an intensive outpatient program to treat patients in more acute phases of addiction. Using Integrated Medication Assisted Treatment, clients receive behavioral and counseling therapies along with medication that stops and prevents opioid urges and reduces symptoms of withdrawal. Research shows that people receiving medication-assisted therapy have a 67 percent success rate after two years, compared withonly 3 percent success for those without medication.*
Once stabilized, patients receive ongoing treatment from primary care practices in local communities (the “spoke”).
The program has been a lifesaver for 35-year-old Sean H. Sean was a longtime former user of heroin who began selling drugs to support his addiction, and his challenges landed him in prison and alienated him from his family. Sean said after his release in February 2017, “I finally decided I wanted to change my life,” and he took the first step toward recovery by enrolling in the EMBARK program, a collaborative effort between MBH, Mid Coast Hospital
and Pen Bay Medical Center.
EMBARK follows best practices for treatment, including individual and group therapy, a social needs assessment for coordination of services like transportation, health education, engagement with peer support services, and support to the next appropriate level of care.
Treatment Is a Journey, Not a Race
Sean met Theodore Logan, MD, a psychiatrist who treats clients with Opioid Use Disorder, at the MBH Rockland program. Logan understands that treatment is a journey, not a race, and that the disease doesn’t discriminate: “It takes time. We look at the whole person, a person who happens to have a substance abuse challenge. Our program draws in people from across our service area, and from every imaginable social strata.”
He added, “Integrated Medication Assisted Treatment helps put the mind in a place to do the work. It takes practice and coping skills. What is unique about our program is that we tailor therapy to the needs of the individual.”
EMBARK’s group-based system enables patients to support, learn from — and be accountable to — one another. It is a successful model that has been expanded to other sites throughout the MaineHealth system.
Thanks to the efforts of the MaineHealth Opioid Addiction Work Group and programs like EMBARK, clients like Sean are on the path to healing and recovery, and poised to move to the next phase of treatment. “All of my family is back in my life. They are proud of me,” he said. “This program is making a difference in my life and in our community.”
* Valliant GE. (1988). What does long-term follow-up teach us about relapse and prevention
of relapse in addiction? Br J Addict. 83(10):1147-57.