Austin Officials See Success With Opioid Treatment Option

AUSTIN, TX — The Community Care Collaborative (CCC) – Central Health’s nonprofit partnership with Seton Healthcare Family – is funding an opioid addiction treatment program with a high success rate, officials said.

The program has measured a 70.8 percent success rate among Travis County participants, which is 16.5 percent higher than the national average. The Medication Assisted Therapy (MAT) pilot project, created in collaboration with Integral Care and CommUnityCare, started about 11 months ago, officials said. To date, 45 patients addicted to opioids such as heroin and prescription pain relievers have been enrolled and are on the path to recovery, according to a press advisory.

The toll from opioid abuse speaks to the need: From 2006 – 2016, 590 Travis County residents died due to opioid drug overdose, a mortality rate of 4.9 out of every 100,000 deaths, officials said.

“MAT provides office-based opioid treatment, comprehensive wrap-around behavioral health and case management services that historically have been out of reach for people with low income, “said Mark Hernandez, MD, Chief Medical Officer and Executive Vice President for the CCC.

Added Craig Franke, MD, Chief Medical Officer and Addictionologist at Integral Care: "Patients are supported by case workers, clinical staff and a doctor, and also have access to psychiatric care. Seventy percent of the people who enroll in treatment are staying in treatment - so we know this approach works.”

Central Health President and CEO Mike Geeslin spoke to the collaborative nature of the initiative: ”Along with our partner Seton, Central Health is a founding member of the Community Care Collaborative. Working with Integral Care, we are all committed to providing quality treatment options for people with low income. We believe everyone deserves the same level and quality of treatment regardless of their income, ZIP code, or experiences.”

MAT uses a medication called buprenorphine/naloxone (brand name Suboxone), a rapid-dissolving oral tablet approved by the U.S. Food and Drug Administration, officials explained. The treatment includes a physician and case worker-monitored detoxification in a local clinic followed by a maintenance period then a possible gradual discontinuation of the medication entirely. MAT doesn’t require expensive hospital or treatment center stays, officials noted.

To qualify for the treatment program, patients must be enrolled in Central Health’s Medical Access Program (MAP), which provides primary, specialty, hospital care, and prescriptions for Travis County residents with low income. In December 2016, approximately 9 percent of MAP patients (about 2,000 people) had a substance use disorder diagnosis including opioid addiction, according to a fact sheet.

“We treat the whole person, not just the substance use disorder,” said Sara Young a Licensed Professional Counselor and the MAT program supervisor at Integral Care, the Local Mental Health Authority for Travis County. “We provide support in the office and in the community as clients begin treatment and assist with housing, basic needs and transportation. We also offer group and individual therapy throughout treatment. We individualize treatment to each client's needs with a goal of preventing relapses and improving their overall health and well-being.”

Ryan’s Story

To buttress the success of the initiative, officials provided a case study narrative. "Ryan" began using illicit drugs when she was 17-years old. By 34, she was regularly using heroin, methamphetamine, cocaine, prescription pain medicine, and marijuana. She had trouble getting and keeping a job and was unable to maintain custody of her daughter.

Tired of her situation and what she described as “the lifestyle of a drug user,” Ryan asked Integral Care for help, where a counselor connected her with the MAT program. Ryan began the program in October 2017 and says she’s been clean since, a statement confirmed by monthly toxicology screenings required by the program. Ryan attends weekly individual and group counselling sessions and works with a doctor to monitor and adjust her buprenorphine dose with the hope of full sobriety by October.

Ryan has a job, is paying her bills and child support, and has secure, safe housing. “There’s hope,” she said. “There really is hope. I’ve been clean since the first day and didn’t experience any withdrawal symptoms or the side effects that you think of with drug detox. If I can get clean, anyone can.”

Background

In Fiscal Year 2018, the Community Care Collaborative budgeted $450,000 for MAT. CommUnityCare and Integral Care partner together to provide clinical and behavioral health support for patients. The funding is expected to pay for 65 patients in FY 2018 and into FY 2019. The Community Care Collaborative was formed in 2013 to create an integrated delivery system for uninsured and underinsured Travis County residents by working with a variety of local health care organizations including CommUnityCare Health Centers and Integral Care.

Opioid-related deaths and emergencies are a growing national crisis, burdening first responders, Emergency Medical Services (EMS), and hospital emergency departments. Nationwide, there was a 30 percent increase in emergency department visits for suspected opioid overdoses between July 2016 – September 2017. Opioid addiction costs the U.S. an estimated $20 billion annually, yet the cost of treating an individual addicted to opioids is only roughly $4,500 a year. Locally, the clinical cost per patient is roughly $4,200. The National Drug Court Institute Practioneer estimates if every opioid-dependent person in the U.S. received treatment, it would save $16 billion a year.

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