For Wendy Greer, it started with a few car accidents.
She had some pain after being involved in a few car accidents, so she went to the doctor and got a prescription for pain medication. And then she kept going. It was easy to play up her pain, and she didn’t think she had a problem. She wasn’t on heroin, after all.
But then she started getting sicker and was charged with a few DUIs. She knew she could go to jail. Her probation officer suggested medication-assisted treatment, and she resisted: To her, that felt like rock bottom.
But she knew something needed to change. And when she began the program, she discovered she actually enjoyed it – and could excel.
What Is Medication-Assisted Treatment?
Medication-assisted treatment (often called MAT) helps patients treat their substance use disorders. Many people are familiar with at least one form of medication-assisted treatment, said Karen Isaacs, MD, MPH: nicotine gum or patches to manage tobacco addiction. Patients who are addicted to opioids, like heroin or prescription pain medicines, receive injections of buprenorphine, an FDA-approved medication to treat opioid use disorders.
Taking buprenorphine safely reduces patients’ withdrawal symptoms and cravings for opioids. To begin medication-assisted treatment, patients must be in the early stages of opioid withdrawal – either because they’ve decided on their own that they want to stop using opioids or because their withdrawal symptoms (or other health issues) have landed them in the hospital, Isaacs said.
When Brandon Smallwood, MD, sees patients with opioid use disorders come through NHRMC’s emergency department, he spends time with them, learning who they are and what they’re facing. That personal touch – combined with a new effort to immediately start patients on medication-assisted treatment in the emergency room – ensured that almost 500 patients received medication-assisted treatment last year. And the medication is helping: There was just a 3% mortality rate for patients who received it in 2020.
Before last year, when patients came to the emergency room seeking medication-assisted treatment, they had to be referred out to Coastal Horizons or another addiction treatment center. That extra step was sometimes one step too many for patients in an already precarious state, Smallwood said. Removing the barrier and allowing them access the medication in the emergency room, right when they needed it, has made a huge difference.
Smallwood is especially passionate about removing as many obstacles as possible and treating these people like patients instead of addicts because of his own history. He has a close family member who has struggled with substance use disorder – and he knows that’s a common fact of life for many people across the country. If you don’t struggle with the disorder yourself, you likely know someone who does, he pointed out.
A Years-Long Process
Many people have a misconception that medication-assisted treatment is a short-term process, Isaacs said. While that can be true for some people, it’s not always the case. Substance use disorder is a tough disease, and oftentimes one bad day can make patients want to use again.
That’s the case for Greer, who has received medication-assisted treatment since 1998. Greer has completed more than 600 hours of group therapy and has volunteered to help other patients, including as the liaison between Coastal Horizons and the Rape Crisis Center. But sometimes she has a bad day – or even a good day – and she uses again.
But she always comes back to medication-assisted treatment.
“Maintenance medication is helping me live a productive life today,” she said.