Confronting the Opioid Epidemic – A Comprehensive Treatment Approach

Behavioral Health News, Fall (2) 2017
By Justin Mitchell, VP, Director of Residential Services & Daphne Juste, Clinical Support Coordinator

 

With more than 60,000 opioid overdose deaths nationally in 2016, a multi-pronged treatment approach is necessary to address the worst drug crisis in American history. Odyssey House is on the front line in treating those diagnosed with the most severe opioid use disorders. Since 2014, individuals admitted to Odyssey House with a primary or secondary opioid use disorder diagnosis has increased by 38 percent. Through a combination of prevention, education, targeted clinical interventions and addiction medication, Odyssey House has established a comprehensive treatment approach that focuses on minimizing the risk of accidental overdose, reducing recidivism and supporting sustainable recovery.

Overdose Prevention

Drug overdose deaths rose approximately 19 percent in 2016, continue to rise in 2017 and are now the leading cause of accidental death in America. In response to this epidemic, Odyssey House has implemented a campaign to raise awareness of the risks and health and safety concerns associated with continued opioid use. This campaign includes the addition of an overdose risk assessment screening, enhancement of key policies and practices, and training of both staff and service recipients on the use of naloxone – the approved opioid overdose reversal medication. In instances of a suspected opioid overdose, the availability of naloxone can be the difference between life and death.

Odyssey House’s Opioid Overdose Prevention Program (OOPP) prepares staff and service recipients to act as first responders in the reversal of an opioid overdose. All staff members receive overdose responder training within 30 days of hire and all service recipients are offered training within 14 days of admission. With 30 qualified Opioid Overdose Rescue Trainers on staff, approximately 250 staff members and over 920 service recipients have been trained to recognize the signs of overdose and to administer naloxone. For added safety, naloxone kits are available throughout our organization including in our residential, supportive housing and outpatient facilities. Additionally, Odyssey House, through our training department and Bronx Recovery Center, provides OOPP training for collaborating organizations, private businesses, families of service recipients, and local community members.

Clinical Interventions

Odyssey House uses well-established clinical interventions and integrated medical services to treat individuals struggling to recover from a substance use disorder. Clinical interventions include evidence-based services such as Motivational Enhancement Therapy, Behavior Modification, Seeking Safety, Thinking for a Change, and Wellness Self-Management Plus. Medical services provide access to primary and psychiatric care and allow for the management of symptoms of both short-term mild/moderate opioid withdrawal and longer lasting post-acute withdrawal.

Psychosocial education begins at admissions and focuses on understanding opioid use disorders, overdose risk and prevention, available addiction medications and relapse prevention. These services are part of an individualized continuum of care, which includes residential, outpatient, and recovery center services.

Medication-Assisted Treatment

The availability of medication-assisted treatment (MAT) is essential to Odyssey House’s opioid use disorder treatment. As part of Odyssey House’s treatment protocol, MAT combines prescribed addiction medications with the available clinical interventions designed to assist, not replace, other treatment and recovery efforts. MAT utilization can increase engagement in treatment and reduce cravings, drug overdose deaths, and infectious disease transmission.

To this end, Odyssey House has established the following goals in integrating MAT into our clinical practices: 1) Screen for a history of opioid use disorders; 2) Educate on available MAT; 3) Assess motivation and the medical and clinical appropriateness to participate in MAT; 4) When appropriate, provide access to addiction medications; and 5) Complete appropriate discharge referrals to providers, which allows continued ambulatory participation in MAT.

In collaboration with community partners, Odyssey House provides access to all three medications approved for the treatment of opioid use disorders. Access to methadone, buprenorphine, and naltrexone (oral and extended-release injectable) allows service recipients, clinicians, and medical providers to establish a treatment plan that meets an individual’s assessed needs, motivation, and discharge plan.

Substance use disorder treatment services remains a critical factor in ensuring that individuals and families are connected with the support services that they need to enter sustained recovery. By combining prevention, education, a full continuum of substance use disorder services and addiction medications, Odyssey House is committed to providing a comprehensive treatment approach to confront today’s most pressing public health crisis.