Expanded Access to Life-Saving Treatment

De Paul / Fora Health's Hillsboro Outpatient Services Clinic

De Paul / Fora Health’s Hillsboro Outpatient Services Clinic.

In December 2020, De Paul / Fora Health was one of five treatment centers in Oregon to receive funding through the Oregon Health Authority (OHA) and the Substance Abuse and Mental Health Services Authority (SAMHSA) to help address our region’s opioid use public health crisis. Thanks to a $600,000 two-year award, we are expanding access to medications to treat opioid use disorders by lowering barriers to access and developing new pathways for patients seeking this highly effective service. Specifically, this funding allows us to hire additional bi-lingual & bi-cultural staff, helping us prioritize care for Lantinx/Hispanic patients served by our Hillsboro Outpatient Clinic. Hillsboro is Oregon’s fifth largest city and 23% of the population identifies as Latinx or Hispanic (US Census Quick Facts). We are grateful to be able to welcome a new Outpatient Medical Services Director, Certified Addiction Counselor, Case Manager, and Peer Mentor to our team because of the award. Funding also helps us establish a telehealth suite to facilitate patient access and supports translation services and educational marketing. The pathways created by this initiative will be scaled up when we move into our new facility, ensuring all patients have access to medication to treat Opioid Use Disorders (OUD), furthering our commitment to evidence-based therapies and tailored, whole person care plans.

OUD is a chronic medical condition caused by the recurrent use of opioids, including prescription drugs such as oxycodone and hydrocodone, and illicit substances such as heroin. According to provisional data from the Centers for Disease Control, the United States experienced over 90,000 overdose-related deaths, the highest number ever recorded, for the 12-month period ending in September 20201. While prescription opioid deaths decreased more than 50% between 2006 and 2018, deaths from synthetic opioids (fentanyl) and heroin have increased since 2015 and opioid overdose hospitalizations have generally increased since 20002. This disease takes a terrible toll on individuals and families, as well as state resources.

In the face of this public health crisis, medications to treat addiction provide a safe, affordable, and effective way to eliminate symptoms of withdrawal, minimize cravings3, and reduce risky behavior that can lead to overdose.4 Additionally, medications that treat opioid use disorder can discourage the injection of illicit drugs, leading to a decrease in the transmission of infectious diseases such as HIV and hepatitis C.5 There are three medications approved by the Food and Drug Administration for use treating OUD: methadone, buprenorphine, and extended release naltrexone. De Paul has been effectively prescribing medication for withdrawal management since 2011 and ongoing prescriptions have been available for residential patients since 2018. This program expansion, however, makes it possible for us to prescribe medication for OUD treatment on an outpatient basis. This program also signals a change in De Paul / Fora Health’s approach to service delivery, moving towards a harm-reduction model of care. Harm reduction refers to a collection of strategies designed to support healthier outcomes for people who use drugs, whether that is managed use, safer use, or abstinence. As stated by the National Harm Reduction Coalition there is no universal definition of implementing harm reduction because harm reduction interventions are designed to meet the needs of the individual and the community.

Removing barriers to care and expanding harm reduction policies are a part of De Paul / Fora Health’s commitment to a patient-centered approach that supports greater health equity. We are grateful for this investment in life-saving care from SAMHSA and OHA and for the community partners, patients, and staff who are helping to make this program a reality.

For more information about medications to treat OUD we recommend reading more at: Medications for Opioid Use Disorder Saves Lives

 

  1. Ahmad FB, Rossen LM, Sutton P. Provisional drug overdose death counts. National Center for Health Statistics. 2021. Designed by LM Rossen, A Lipphardt, FB Ahmad, JM Keralis, and Y Chong: National Center for Health Statistics.
  2. Oregon Health Authority, Public Health Division. Opioid overdose in Oregon: Report to the Legislature. Portland, OR. September 2020.
  3. Richard P. Mattick et al., “Methadone Maintenance Therapy Versus No Opioid Replacement Therapy for Opioid Dependence,” Cochrane Database of Systematic Reviews 3 (2009): CD002209, http://www.ncbi.nlm.nih.gov/pubmed/19588333; Sandra D. Comer et al., “Injectable, Sustained-Release Naltrexone for the Treatment of Opioid Dependence: A Randomized, Placebo-Controlled Trial,” JAMA Psychiatry 63, no. 2 (2006): 210–8, http://archpsyc.jamanetwork.com/article.aspx?articleid=209312; Paul J. Fudala et al., “Office-Based Treatment of Opiate Addiction With a Sublingual-Tablet Formulation of Buprenorphine and Naloxone,” New England Journal of Medicine 349, no. 10 (2003): 949–58, http://www.ncbi.nlm.nih.gov/pubmed/12954743.
  4. Robert P. Schwartz et al., “Opioid Agonist Treatments and Heroin Overdose Deaths in Baltimore, Maryland, 1995–2009,” American Journal of Public Health 103, no. 5 (2013): 917–22, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3670653.
  5. Judith I. Tsui et al., “Association of Opioid Agonist Therapy With Lower Incidence of Hepatitis C Virus Infection in Young Adult Injection Drug Users,” JAMA Internal Medicine 174, no. 12 (2014): 1974–81, http://archinte.jamanetwork.com/article. aspx?articleid=1918926; David S. Metzger et al., “Human Immunodeficiency Virus Seroconversion Among Intravenous Drug Users In-And Out-of-Treatment: An 18-Month Prospective Follow-Up,” Journal of Acquired Immune Deficiency Syndromes 6, no. 9 (1993): 1049–56, http://www.ncbi.nlm.nih.gov/pubmed/8340896.