Program combines buprenorphine with counseling
BY DAN HILDEBRAN
Monitor Editor
KEYSTONE HEIGHTS— Clay County Fire Rescue has a new program to help people addicted to opioids.
Stephen Teal of the department’s paramedicine team told the Keystone SafetyNet Alliance during its September meeting that the program includes up to seven days of treatment with the drug buprenorphine, combined with counseling from Clay Behavioral.
Teal said buprenorphine, also known under the brand names of Subutex and Suboxone, is used to help people break their dependency on opioids.
“I kind of refer to it as the newer, safer version of methadone,” Teal said. “People were able to actually wean off of this medication much easier than they can off of methadone, so we’re getting them onto that.”
Teal said that anytime Clay County Fire-Rescue administers Narcan, which is used for opioid overdoses, the patient is offered enrollment in the county’s paramedicine program.
He added that the program now has ties to emergency departments at Orange Park Regional Medical Center and St. Vincent’s Clay where physicians can administer the first dose of buprenorphine and the paramedicine team contacts the patient soon thereafter.
The patient then receives daily doses of buprenorphine for up to six additional days. Teal said program participants are also evaluated by the team over the treatment period.
“We physically score you, get vitals on you, assess you daily,” he said.
Teal added that confidentiality is provided to patients who request it.
“We have some people that tell us their families don’t know they’re using,” he said. “That’s fine. Meet us at McDonald’s, wherever. We’ll meet you wherever you want.”
Day-to-day help
Teal said the counseling support from Clay Behavioral is an essential part of the program.
“When you’re having a bad day that’s who you call,” he said. “If you just need somebody to talk to, you call. They’ll come out. They’ll sit with you. They’ll talk to you on the phone. They go above and beyond to make things happen.”
Teal added that the support from Clay Behavioral goes far beyond discussions about addiction.
“They pick people up to make their doctor’s appointments,” he said. “A lot of our clientele has transportation issues, not only vehicle (problems). A lot of it is suspended licenses. There again, we’ve gotten with the tax collector’s office, and they are also assisting us with people having issues with their driver’s license.”
Teal said the staff at Clay Behavioral helps the patient identify the root cause of the addiction.
“They get into, as we tell them, the nitty-gritty,” he said. “It’s going to bring up some emotions of why you’ve gotten where you’re at.”
He added that at around Day 3 or 4 of the program, the patient meets with a doctor at Clay Behavioral for diagnosis and a treatment plan.
Barriers to success
Teal said sometimes potential enrollees in the program can’t make it to appointments at Clay Behavioral within the 8 a.m. to 4:30 p.m. business hours.
“We try and work with them the best we can,” he said, “but if they can’t make all the appointments for Clay Behavioral…we can’t take them in if they can’t do the second half of the program.”
Teal said that family members of addicts hear about the program and want their loved ones to participate, only to find out the addict has no interest in the treatment.
“You can lead the horse to water, but you can’t make it drink,” he said. “Until these people are ready and want to get into a program, they’re not. It’s just not going to happen.”
He also said some people abuse the program.
“We’ve had people that came in that only wanted a daily fix, because the buprenorphine basically helps curb the cravings of wanting to use,” he said. “We’ve had people come in that didn’t have money (to buy opioids). They came into the program. We got them signed up, (and) they disappeared the next day because they found more money.”
Teal said that eligibility into the program includes being 18 or older, a Clay County resident and not currently using methadone.
“I say ‘currently’ as in if somebody has been off methadone for a couple of days, we’re in a good spot.”
Teal said that for people who live outside of Clay County, other alternatives are available.
“We might have other programs we can hook them up with if it’s not with ours,” he said. There are other groups, other programs that kind of do the same thing.”
Clay County’s Community Paramedicine Program is free to participants and is funded by a State of Florida Overdose-to-Action grant administered by the Florida Department of Health and Clay County Fire Rescue. The program’s email address is [email protected].
