Even amid a crippling opioid crisis, medication-assisted treatment for opioid use disorder remains highly controversial in the state where April Barnes, RN, works. At this month's Rx Drug Abuse & Heroin Summit, the outreach director at Nashville, Tenn.-based The Next Door will argue for a treatment approach that fully integrates physical, emotional and spiritual components.
“Many other ministries have great programs but don't have medication,” Barnes tells Addiction Professional. “We've had difficult situations where it's hard to find a placement for a patient, because at many facilities the patient can't be on medication.”
At her April 25 workshop session at the Atlanta conference, Barnes will outline how the faith-based treatment organization where she works has moved in a different direction from some similar programs. The Next Door was launched 15 years ago as a halfway house for women reintegrating into the community from incarceration, and has grown into a multi-level treatment provider at a time when the opioid epidemic was intensifying in the state and nationally.
“We've always been about adapting to what the greatest need is in the community,” says Barnes, who formerly served as director of admissions and business development at The Next Door. “With the number of overdoses that were occurring, that's when it went from strictly re-entry into treatment. We've been learning and growing over the last five years.”
Chronic illness factor
Barnes sees the role of medication treatment for opioid use disorder in the same way she views medication for type 2 diabetes: an essential component but not the cure-all. Medications such as buprenorphine can keep the patient alive and engaged so that there is time for the other elements of comprehensive treatment to have an effect, the logic goes.
“You're not going to achieve complete healing unless you have all of the components,” Barnes says, referring to the physical, emotional and spiritual. “All these areas of human life are interconnected.”
That is not an attitude universally put into practice in faith-based programs, however, she suggests. Barnes will discuss in her session how The Next Door's perspective has evolved over the years.
“Even within our own facility, we were for years abstinence-based,” she says. “This took some time even for our leadership, for our team, to stop moralizing it.”
The Next Door has inpatient capacity for 82 female patients (12 detox beds and 70 residential beds). It is now adding to its outpatient offerings a recovery care clinic where medication-assisted treatment will be at the core of programming.
Buprenorphine and extended-release naltrexone are both available to patients in programs at The Next Door. The organization has a diverse payer mix that includes both public and private insurance sources.
Barnes says she still sees a great need for community education on the importance of comprehensive, integrated treatment. “When I tell people we're a faith-based program, they often say, 'Oh, you must not prescribe,'” she says. “We absolutely believe in the power of prayer, but we also believe in science.”
The Rx Drug Abuse & Heroin Summit, April 22-25 in Atlanta, is where solutions are formulated, stakeholders from Federal to family convene, and change begins. It is the annual gathering for stakeholders to discuss what's working in prevention and treatment. For more information, visit rx-summit.com