Bringing medication-assisted treatment to those recovering from opioid addiction has become even more important amid the COVID-19 pandemic.
“The loss of connection that everyone is feeling now hits those fighting addiction even harder, increasing the chances that those in recovery will begin using again,” explained associate professor Jennifer Ball of SDSU’s Department of Pharmacy Practice. “Addiction is a disease of lost connections because it has so much to do with trauma and a lack of support.”
Ball is part of the Center for Family Medicine’s medication-assisted treatment addiction care team, which is treating patients and training professionals to deliver medication-assisted treatment for opioid addiction. The team, led by Dr. James Wilde, includes nurse case manager Cindy Genzler and therapists Daniel Felix and Mary Jones. Recently, Caroline Vernon of the Carroll Institute in Sioux Falls joined the team as an outpatient therapist.
Between June 2019 and May 2020, 160 people received medication-assisted treatment for opioid addiction with nearly 90% still engaged in treatment for a year or more either through CFM or other treatment providers. Furthermore, the CFM team has continued to see many of its patients in person using COVID protocols.
Though telehealth is available, a survey of patients showed “the majority still want to come in person,” Ball said, pointing out, “so much comes from being there in person, getting to know the individual and developing rapport and trust.”
The South Dakota Department of Social Services provides support to those offering addiction services through funding from the Substance Abuse and mental Health Services Administration. The CFM program has received nearly $760,000 in contract funding since 2018.
The funding pays for the first six months of treatment medication as well as all office visits, Ball said. “We are lucky the state has been so supportive. Without it, we would have a lower number of patients able to stay engaged in care.”
The team has partnered with Minnehaha County to allow patients who are already receiving medication-assisted treatment for opioid use to continue their treatment in jail. “It’s been very positive. Patients struggle getting back to treatment after being released from jail and that increases the risk for overdoses,” Ball explained. Previously, Yankton County Jail was the only jail that allowed patients to continue on treatment.
Ball also looks forward to working with the Link Community Triage Center, a new 16-bed facility in Sioux Falls that will provide help to those dealing with behavioral health issues and addiction. The center opening, previously scheduled for October 2020, was delayed to May 2021 due to the pandemic.
Between June 2019 and May 2020, 58 medical providers or medical students received MAT education and 10 of those have earned the waivers required to administer the opioid treatment medications.
In addition, the CFM team partnered with the University of South Dakota Sanford School of Medicine to offer an elective course on medication-assisted treatment for opioid-use disorder for medical students. The class was moved online due to the pandemic.
Each year, 14 pharmacy students receive training as well; however, the students’ clinical training rotations were done virtually due to the pandemic.
Rather than working with two students every five weeks, Ball was able to give the entire class some experience in addiction care, including meeting with patients who shared their stories virtually and participating in case simulations. “I was able to add in some activities to engage students,” she said.
Reaching rural communities
As part of Avera Health’s Project ECHO—Extension for Community Healthcare Outcomes—the CFM team increased the number of participants in its half-day MAT training sessions to an average of 33. The 18 half-day sessions drew participants from 66 health care facilities.
“The style of learning is for active professionals. We discuss cases as they come up with everyone providing input along with lectures on specific topics. It connects a lot of the webinar learning with the treatment process to create experts among practitioners in rural areas,” Ball explained.
Two ECHO participants from Sisseton have started a medication-assisted treatment program for opioid addiction in their community. “We gave them the tools to get started and they partnered with Project Recovery, the largest telehealth recovery program in the state,” Ball said. That program is now treating 30 patients.
“Seeing the growth our training has produced is exciting. It gives us hope that what we are doing is changing opinions and this change in attitudes is perhaps the most vital for long- term treatment and success across South Dakota,” Ball concluded.