Witnessing the increasing rates of relapse and overdose deaths among heroin addicts in the Louisville area in recent years, the Morton Center addiction treatment facility has now decided to begin offering medication-assisted treatment (MAT) to its patients, citing research that shows prescribing drugs such as Suboxone and Vivitrol along with therapy can offer many patients a greater chance at recovery.
Morton Center CEO Priscilla McIntosh tells Insider Louisville that this decision was made due to the changing nature of their patients’ addictions, as four years ago they mostly dealt with alcoholism, but now are increasingly treating those addicted to heroin. Noting that the typical relapse rate for addicts receiving only therapy or counseling is 90 percent — and those using heroin are at significant risk for an overdose death when they relapse — she says years of researching the issue led them to the conclusion that they also needed to offer MAT to such patients.
“People can absolutely die from alcohol poisoning when they relapse, but when you look at the number of deaths that are happening because of heroin, there’s just no comparison,” says McIntosh. “We’ve been around for 32 years and we’re dealing with a situation with heroin that is much different than any type of substance abuse we’ve dealt with before… It’s a scary situation, and we have to adapt with the times, because people are dying every day.”
Over 90 percent of addiction treatment in America consists of the abstinence-based 12-steps model of Alcoholics Anonymous, but a growing consensus of peer-reviewed research and physicians in the field suggest that MAT is more effective. In the Louisville area, behavioral health care provider Seven Counties Services recently made the leap with a new MAT program utilizing Vivitrol and Suboxone along with intensive outpatient therapy, but others such as The Healing Place still resist such treatment, arguing that medication such as Suboxone can be abused and is just trading one addiction for another.
“We have been trying to figure out what we can do over the last two years, because our mission and what we always strive to do at the Morton Center is build a treatment around each individual,” says McIntosh. “We looked at studies at Hazelden and other places to see what worked for them, to make sure we’re doing the best that we can to give individuals the best option… This type of medication, as long as it’s able to be monitored in the right way, can really make a difference for people.”
Vivitrol is administered through a monthly injection of the non-narcotic drug naltrexone, which attaches to opioid receptors in the brain to block drugs like heroin and prescription painkillers from having their typical euphoric effect. Suboxone is a film or tablet taken under the tongue daily that mostly consists of the opioid buprenorphine, which partially blocks the same receptors in addition to reducing withdrawal symptoms. While buprenorphine can initially produce a much milder high, Suboxone also contains naloxone, an overdose anecdote that will send a user into an immediate and unpleasant withdrawal if it is melted down and injected in an attempt to get high.
The Morton Center will begin offering both medications as an option for patients on May 20. There are currently strict federal limits on how many patients a doctor can prescribe Suboxone to, but the facility has an experienced psychiatrist who will be able to treat 100 patient at a given time — which may expand to 200 by the end of this year once newly proposed federal rules are finalized.
McIntosh says each patient will be given an initial assessment by a licensed therapist and then discuss the possibility of MAT with their medical director, which will only be available to those who attend their three-to-four day a week therapy sessions. Those prescribed Suboxone will only be given short-term prescriptions, and staff will closely monitor those patients with several types of drug screens to make sure they are not diverting or abusing any opioids.
“Just because they’re coming to the Morton Center and going into our intensive outpatient program does not mean that they’re going to be on any type of medication, it’s going to be based on where this individual is and how we can help them,” says McIntosh. “The only way that they would be able to be on that medication is if they are in our treatment, and they would not be able to come in and just get a 30-day script.”
The Morton Center — located at 1028 Barret Ave., bordering the Highlands and Germantown neighborhoods — currently provides outpatient counseling and therapy for 350 individuals per week, and roughly 1,300 per year. McIntosh says they are one of the only addiction treatment providers who offer a structured counseling program not just for those who are addicted, but also for that patient’s family, loved ones and co-workers who are trying to understand and deal with that person’s addiction. For patients who are in the treatment program, additional loved ones can take the support system program at no additional costs.
“It’s very comforting to be able to walk into a place and know there are others struggling and going through the same thing that you’re going through, because often as a loved one it can be very embarrassing to talk about that, even with your best friends, and especially with your co-workers,” says McIntosh. “Many times when a family member comes to us they say ‘if they really love me, they would just stop.’ That’s not the case, it’s not that easy to be able to do that.”
McIntosh says such family support also can have a significant impact on the patient’s success, as those who have family members attend at least three nights of their program are three times more likely to be able to stay sober and finish the program at the Morton Center.
“They say for one individual who is struggling with an addiction, there’s 12 other people who are effected,” says McIntosh. “I strongly believe from my own personal experience — and hearing the struggles of other people here at the Morton Center — that it’s triple that number, if not more.”