Virginia facilities expanding medication treatment access for substance use disorder

ROANOKE, Va. (WDBJ) - More people across the Commonwealth will soon have access to medication assisted treatment, or MAT, for opioid use disorder. It comes as Carilion Clinic and the Virginia Department of Corrections expand pilot programs.

It’s something advocates such as “Dopesick” author Beth Macy and peer support specialists have pushed for in recent years - specifically the prescription of buprenorphine for addiction treatment coupled with therapies and wraparound services.

Experts say with those things combined, a person’s chances of recovery go way up.

Now there are efforts to support those most vulnerable, at emergency rooms and at points of incarceration.

“This is so within our wheelhouse; we can do this,” said Dr. Cheri Hartman, Grant Project Director in Carilion Clinic’s Department of Psychiatry and Behavioral Medicine.

She has encouraging words for doctors statewide as Carilion Clinic hits the road. After 11 years in addiction treatment at the hospital, she’s ready to take successes she’s seen in Roanoke across the Commonwealth.

“And maybe, you know, get lots more people into treatment, which will be protective, and potentially life saving for them,” she said.

Thanks to a $1.9 million grant from the Virginia Department of Health’s Injury and Violence Prevention Program, Carilion will expand its ED Bridge to Treatment program to seven other hospitals. The grant will provide for trainings, a conference and a digital toolkit.

“It’s not a difficult challenge to embark on this model,” Hartman reassured.

The Bridge program logs success in getting people from the emergency room to treatment.

“We probably went from about 10 percent, at best, getting into treatment, after presenting in the ER with an acute symptom of opioid use disorder, to after putting that model in place, at the end of the first year, we had 82 percent,” she said.

In Year 1 of the program, more than 90 percent of participants remained in treatment for one month. Long-term recovery is harder to track, but it’s something her office is focusing on. Once the Bridge Program was implemented, Hartman’s office-based opioid treatment program went from around 150 to participants to more than 450. Patients are met with peer support, therapies, wraparound services and medication like buprenorphine.

“Being dependent on a medicine is different than being addicted to it,” she explained. “Dependence on the medicine improves your functioning, and that’s the bottom line.”

Hartman said buprenorphine reduces cravings in persons suffering from substance use disorder. Patients get a prescription from their doctor and usually take it daily. Dissolving the tablet in your mouth, Dr. Hartman says, metabolizes the medication, affecting the part of your brain that can suppress your cravings. Unlike other opioids, she said it has a ceiling.

“It very strongly attaches to that neuron,” she said of the medication. “And so when it docks in there, it holds on real tightly. And so if you take something else, it will actually protect it from heroin’s impact, because you take heroin and you’re trying to, you know, activate that cell stronger, but buprenorphine won’t let it.”

Doctors no longer need a waiver to prescribe it, but she says there is still stigma about it in the medical community. But come June, she said every doctor in this country renewing their medical licenses will need to demonstrate proof of training in addiction screening and pain management. She calls it a big win for making sure the medical community treats our opioid crisis and prevents it from worsening.

This comes as the Virginia Department of Corrections independently announced an expansion of its own.

“The mission of the Virginia Department of Corrections is to help people to be better,” said spokesperson Kyle Gibson.

Starting this month, six DOC facilities across the Commonwealth, including Green Rock Correctional in Chatham, expanded access to oral and injectable buprenorphine inside facilities. Now anyone entering with a prescription will be able to continue treatment. Previously, buprenorphine was only available to people sentenced to the Community Corrections Alternative Program.

This, the VADOC said in a press release, will be coupled with ongoing counseling, case management, peer support, and substance use disorder programming.

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