Opioid Users Motivated To Stay in Treatment Longer

With help from navigators and a seamless admissions process, award winning program at Kings County Hospital Center keeps patients from abandoning drug treatment early, which can set back recovery from addiction.

	Members of the Kings County team: (l,r) Anse Toussant, Dominique Michel, Maria West and Godwin Otasowie.

Dominique Michel, an addiction counselor at Kings County Hospital Center, remembers the day the 24-year old heroin addict come to treatment.

“He was confused, conflicted and unsure of what to expect,” recalls Michel, a team leader and patient navigator who guides incoming clients to help make the admissions process more seamless. “The chances of him making it through the first day were questionable.”

The patient was about to go through the required and comprehensive process for admission into the drug rehab program at the hospital, which was recently made more efficient and now takes half the time to receive a mental health evaluation and observation after receiving methadone treatment.

“I shadowed him from beginning to end. He knew he had someone to call on at any point of the process. And at the end, he said: Ms. Michel, quite frankly, if you were not there, I probably would have left.”

The young man has since remained drug-free and in treatment, exceeding the ideal length of stay in the program of 30-days, which drug rehab experts cite as one of the best indicators to ensure recovery from addiction.

	Dr. Susan Whitley

"Remaining in treatment for an adequate period of time is critical and it requires a strong commitment by the patient. When patients abandon treatment early it becomes almost impossible to recover from their addiction," said Susan Whitley, MD, Director of the Chemical Dependency Services at Kings County Hospital Center.

The substance abuse treatment program at Kings County is an intensive, outpatient program that requires participation in one to one counseling, group therapy and medication treatment. A variety of therapeutic sessions are also offered, including art therapy, smoking cessation, and even career counseling. Clients are expected to attend almost daily, from Monday through Saturday, to get the most value from the customized program that’s designed for them.

After adopting a series of clinical interventions and operational strategies, including reducing wait times for admission, assigning patient navigators like Michel, and offering peer support for opioid users, the hospital achieved a 95 percent retention rate for its 30-day treatment program and exceeded the New York State standard of 90 percent.

The high patient retention rates earned Kings County Hospital this year’s Science and Service Award from the Substance Abuse and Mental Health Services Administration (SAMHSA), the federal agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation.

"It’s very reassuring to be recognized as a national leader in treating opioid-related disorders and for our ability to engage and motivate patients through their road to recovery and a drug-free lifestyle,” said Joseph Merlino, MD, Director of Behavioral Health at Kings County Hospital Center.

As a patient navigator, Michel also helps clients resolve some of the common barriers to the patient remaining in care, such housing, transportation, or childcare needs. Many also have complex medical and mental health needs that have often gone unattended, like the 46-year old female who recently came for drug treatment, was HIV positive and demonstrated signs of depression after experiencing the death of her son.

“That case was heart-breaking,” recalls Michel. “But I could not let her leave that day without resolving some of her other issues.”

Michel was able to help the patient get medications she had gone without for months, and secured an immediate appointment to resume HIV treatment.

Kings County Hospital’s opioid dependency treatment program has capacity to treat up to 750 patients at a time who are addicted to opioids like morphine, heroin, codeine, and oxycodone.

In recent years, there has been an increase in the number of New York City residents reporting misuse of these drugs. Between 2002-2003 and 2008-2009, self-reported non-prescription opioid use increased by 40 percent. In 2011, opioid analgesics were involved in 220 unintentional deaths in New York City, a 65 percent increase from 2005.

Hospital officials credit the success of their drug treatment program to the patient-centered approach to care practiced by the physicians, nurses, social workers and other counselors on that team, and their efforts to connect with clients on a very personal level and quickly access the complexity of the client’s lives.

“Substance abuse is not their entire story. They have family, they have children, they have professions. This is just one aspect of their lives,” says Michel. “Our job is to encourage them. Show them we care. Let them know there’s light at the end of the tunnel.”

“I’m always amazed at our client’s resilience. And I take great comfort in knowing we planted the seed to a drug-free and better future,” added Michel.