ASU Presents: The Experts on MAT | Episode 6: Opioid addiction is everywhere
ASU Presents: The Experts on MAT | Episode 6: Opioid addiction is everywhere


[NICK]: Should we start with a tour? [BRYCE]: Yeah. [NICK]: Yeah. Let’s do it. [NICK]: Okay. Patients come in through the
door. The first thing they do is go check-in right here at the front desk. If they have
to give a UA sample or see a counselor or see a medical provider they’ll be told right
there and then. If they’re just receiving their medication then they’ll be put in
the queue. They’ll meet with a nurse to receive their dose of medication. [FRANCESCA]: How many people do you see a
day come in here? [INTERVIEWEE]: Approximately 500 a day. They’re
no longer having withdrawal symptoms, so that’s why you see so many coming in because they
do feel better. [NICK]: Yeah. The way methadone works in your
brain is it actually stabilizes your brain chemistry. When somebody stops using heroin
their brain chemistry stops producing endorphins on its own. You can replace those missing
endorphins with a medication like methadone or suboxone, and so it stops withdrawal. In
the first 90 days in treatment you’re allowed one take-home dose and that’s on Saturdays. [BRYCE]: Is there concern about diversion? [NICK]: Typically not. We do diversion checks
all the time too. If a patient does have take-home privileges—even the patients that have 28-day
take-home privileges we’ll call them back randomly throughout the month and have them
bring their bottle in because the bottles are actually sealed. They’ll have to bring
in the supply that they have left. If they’ve used more than they should have then that
means they’re not using their medication as intended. If somebody wants to divert methadone
or an opioid this is the hardest way to get access to it. [NICK]: To actually qualify for the diagnosis
opioid use disorder there’s a number of criteria that have to be met. You have to have been
using for a certain amount of time or had gone through detox a couple of times. Once
those criteria are met then you would be able to receive treatment from us, medications
such as methadone, suboxone or vivitrol in conjunction with the psychosocial therapy.
The research is starting to show that about three years in treatment is the amount of
time it takes. When you actually look at brain scans of people who are suffering from opioid
use disorder you’ll see that at the two-year mark their brains are still starting to stabilize
from the heavy opioid use. That’s why if you put somebody through detox that has an
opioid use disorder through a 28-day abstinence based residential treatment program it’s
not gonna phase them because their brain’s gonna be healing for the next two years. The
medication really helps their brain stabilize so that they can deal with the psychosocial
components that might be the root cause of their addiction. That’s why we do the therapy
in conjunction with the medication. [BRYCE]: You talked about the need because
of such an epidemic. What are you doing right now to address the need? [NICK]: Well, it’s ironic. Even if the need
wasn’t growing the epidemic is growing if that makes sense because the need’s always
been there. For the last couple of years there’s a large amount of people in this country who
are not getting treatment, but are not even acknowledging that they need treatment, so
95.5 percent of active drug users don’t acknowledge that they need help. The issue
of identifying, engaging people who need to get into treatments, right, that concept right
there is something that we actually don’t talk a lot about. What do you say to somebody
to get them to get into treatments? [NICK]: I lost a sister to a heroin overdose.
I ask that question all the time, “What could I have done?” We did interventions
and stuff like that. You hear people say, “I hit rock bottom over and over again.
I overdosed three or four times before getting into treatment.” It’s not necessarily
hitting rock bottom that gives people that ah-ha moment, and so how do you engage those
people to get into treatment? Well, that’s what we need to figure out. If you could get
clinics closer to the people in need then you’re gonna break down more of the barriers
that are stopping them from getting into treatment. The easier we could make it for people to
get access to treatments the more people are gonna get into treatment because addiction
is a disease that’s constantly telling people not to get into treatments. We need to provide
all means necessary to break down any of the barriers in their mind that’s stopping them
from getting into treatment. [NICK]: We opened the first 24/7 clinic like
this in the country back in October, and we’ve intake 4,000 patients in the first year. We
did that because we like to think of it as this moment of hope. That’s what we call
it where somebody might make a decision at 3:00 a.m. to get into treatment. If you don’t
get them into treatment right then and there an hour later they might change their mind.
We do open at 4:30 in the morning our clinics, so people could get their medications prior
to going to work. The research actually shows in our clinics, our own internal research
shows that employment rates increase by about 78 percent at the 6-month mark when people
enter treatment. [NICK]: When we opened the 24/7 clinic I think
AZ Republic covered the clinic and interviewed a patient, and she entered treatment. She
had been on heroin for four years and entered treatment. Two weeks later she came in and
she said I got reunited with my kids that were taken away from me and I have two jobs,
two weeks into treatments. When you bring in medication assisted treatment into the
environment overdose death rates decrease by 75 percent. They’ve actually looked at
entire countries like China pre MAT and post MAT and seen the same thing, 75 percent decrease
in overdose death rates when you bring in medication. We do the research on where there’s
high rates of overdose death rates, and we open clinics in those neighborhoods. [NICK]: Even here in Mesa when we tried to
open it took us a while to get this facility. On this street, here, we had a multitude of
landlords that wouldn’t rent to us, sellers that wouldn’t sell to us. We went to get
a conditional use permit on a piece of property. They called us the night before and said don’t
even come, don’t bother showing up because we’ve had so much opposition to your treatment
program. I remember talking to one guy and he said, “I’ve had my building broken into
five times in the last week by drug addicts, and they’re leaving needles.” This is
right up the street from here. I’m like, “What do you wanna do about that? Do you
wanna stick your head in the sand and think it’s just gonna—problem’s gonna go away?
Do you wanna have more police presence to arrest them? Let’s think about pragmatic
solutions here. What are you gonna do? Bringing a treatment center is what’s going to treat
the patients. Why wouldn’t you be more welcoming of that?” [BRYCE]: Just right here in this neighborhood
it was a problem? [NICK]: Oh yeah. It’s a problem in many
neighborhoods. Would you talk about your sons or daughters like you talk about our patients?
Because at some point we’re all gonna be impacted if we haven’t been already by an
addiction in our immediate circle of friends or family. These are our fellow Americans,
fellow human beings, whatever perspective you wanna look at it from. I don’t understand
not helping people that are in need and not wanting to help people in need. I think if
we approach addiction from a place of compassion we’re gonna have more success. I think everybody’s
starting to realize that.

1 thought on “ASU Presents: The Experts on MAT | Episode 6: Opioid addiction is everywhere”

  1. Natasha Willis says:

    Such a great behind the scenes look into the everyday struggles of those going through opioid dependence. Great docuseries!

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