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Presbyterian program takes stigma out of substance abuse

Presbyterian Healthcare Services is taking a new approach to working with patients whose health is affected by substance abuse that has become part of their lives.

Dr. Daniel Duhigg, an addiction psychiatrist and Presbyterian’s clinical program medical director of behavioral health, says the decades-old approach of stigmatizing and punishing people because of their addictions isn’t helpful.

“It clearly has not worked. Putting people in prison doesn’t get them any closer to improvement,” Duhigg said.

The Substance Use Disorder and Community Collaborative initiative started in May 2017 approaches addiction in the same way other diseases, like diabetes or heart problems, with scientifically evaluated treatment.”We are working thoughtfully and diligently to have as much compassion as possible to overcome a history of a culture of stigmatizing people who live with this illness,” said Duhigg.

He said the growing opioid crisis – which has garnered national attention – played a significant role in Presbyterian’s commitment to addressing this area of need.

The program began at Presbyterian hospital in Albuquerque and expanded recently to Rust Medical Center in Rio Rancho and to Presbyterian hospital in Española. Here’s how it works.

Intervention teams at those hospitals identify patients with potential substance abuse disorders – those living with alcohol or drug abuse may show up at a hospital with health problems such as cirrhosis of the liver or abscesses caused by using dirty needles. The team evaluates range of services the patient may need. Those may include psychiatric and medical treatment and follow up support after discharge.

Recovery Specialist Chris Lucero plays a key role in this approach. Lucero overcame his own addiction to drugs and alcohol through a 12-step program in 2001 and has worked with many support programs since. He talks to patients as a peer, helping them see a path to turn their lives around.

“When I share my story, they realize recovery is possible,” Lucero said. “I address that person holistically. I’m there to support them in whatever they choose to do.”

Lucero helps connect patients with support groups and services in their community and schedules follow-up appointments for them if needed.

More than 1,350 patients have been involved in the program since it started 11 months ago.

Education is another critical component of the program. Presbyterian’s teams work with community groups such as churches and faith-based organizations to train people how to recognize signs that someone is struggling with substance abuse and let them know where they can seek supportive help.

They also offer training to clinicians on how to use medication therapy with Suboxone or Buprenorphine to treat those with addictions to opioids like oxycodone or heroin.

The Pain and Addictions ECHO clinic was added to the program in January. The weekly video conference enables providers from hospitals and clinics throughout Presbyterian’s network to connect with a panel of experts in addiction psychiatry and chronic pain management. Those who participate can present and discuss cases with the experts.

The format is based on a telehealth model started by the University of New Mexico in 2003 to assist rural physicians.

At a recent session, family practitioners, nurse practitioners, pharmacists, pediatricians and other specialists joined in to hear a presentation on harm reduction, including how naloxone can be used to reverse the often fatal effects of an opioid overdose.