Patients with opioid addiction who show up in a hospital's ER face many barriers to recovery, and so do the doctors trying to help them. Easing those barriers on both sides helps patients get into good follow-up programs that lead to lasting change.
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Each mobile clinic has a nurse, a counselor and a peer specialist — all trained to drive a 34-foot-long motor home. "I never thought when I went to nursing school that I'd be doing this," says Christi Couron as she pumps 52 gallons of diesel fuel into the vehicle.
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Costs have gone up for addiction treatment centers in recent months, as they have had to invest in teletherapy and personal protective gear. "We are at risk for not having the funding that we need to keep our doors open," says one medical director.
Arthur Jackson watches as visiting nurse Brenda Mastricola changes the bandages on his foot. He needs a continuous dose of IV penicillin to treat a serious bone infection, and doctors decided he could safely get the treatment at home, despite his history of opioid addiction.
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Paul Williams (left) helps Scott Beatty build his 'backpack' guitar. It has a smaller body, meant to easily fit in a pack. Beatty is in the Culture of Recovery program which teaches instrument making to people recovering from addiction.
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Dr. Peter Grinspoon was a practicing physician when he became addicted to opioids. When he got caught, Grinspoon wasn't allowed access to what's now the standard treatment for addiction — buprenorphine or methadone (in addition to counseling) — precisely because he was a doctor.
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Travis Rieder, author of In Pain: A Bioethicist's Personal Struggle With Opioids, says none of the doctors who prescribed opioids for his waves of "fiery" or "electrical" pain taught him how to safely taper his use of the drugs when he wanted to quit.
Barb Williamson runs several sobriety houses in Pennsylvania, commercially run homes where residents support each other in their recovery from opioid addiction. Initially, she says, she saw the use of Suboxone or methadone by residents as "a crutch," and banned them. But evidence the medicines can be helpful changed her mind.
Bea and Doug Duncan outside their home in Natick, Mass. The coaching they got from the Community Reinforcement and Family Training program, they say, gave them tools to help their son Jeff stick to his recovery from drug use. He's 28 now and has been sober for nine years.