Despite fading from mainstream news, the opioid and related substance use crises are still with us. In fact, according to Brittany Stout, a Family Nurse Practitioner, the opiate crisis has reached new peaks.

Stout, who has led broad efforts to address and treat substance use in the greater Orange County Indiana area, has spearheaded efforts to elevate the quality of healthcare available to those facing substance use. Instead of treatment only being available through substance use and other treatment centers, Stout and Southern Indiana Community Health Care now increasingly integrate substance use treatment into family healthcare services.

This includes the local administration of MAT (medication-assisted treatment) options, where people facing substance use can be prescribed Suboxone or Vivitrol without having to travel to a specialty clinic (MAT treatment also typically includes a combination of counseling and behavioral therapies).

Properly administered, Suboxone can blunt intoxication from using drugs like heroin, oxycodone and other opiates, reducing cravings and allowing people an opportunity to transition away from a life of substance use. Injectable Vivitrol is also available through a MAT program, which use blocks euphoria or ‘high’ that alcohol and opioids produce. Vivitrol has also proven effective in helping people with substance use issues recover.

“There is still a stigma around substance use, and this stigma serves as a barrier to seeking treatment for those who need it,” Stout said. “By integrating MAT options within family medical treatment, this provides several advantages, including helping those facing substance use issues with improving their general health and also addressing issues like diabetes.”

(Recognizing that physical health and mental health go together, Southern Indiana Community Health Care utilizes an integrated care model. For more information, please visit https://sichc.org/mental-health/)

People with substance use issues can go to a typical facility like SICHC’s Valley Health clinic in West Baden Indiana and confidentially receive treatment. “My MAT patients sit in the same lobby as patients seeking healthcare for other reasons,” Stout said. “They don’t have to drive a long distance to a specialty clinic or face the stigma of publicly going to that clinic.”

With the federal removal of certain data waiver requirements, MAT treatment became a viable option to integrate within more typical medical services. This is now more important than ever, according to Stout, as new illegal drugs in pill form that “look like” opiates are becoming more available on the street. “Dealers mix up illegal and highly dangerous combinations of fentanyl, heroin and other drugs, and illicitly press them in pill form to ‘look like’ oxycodone or other opiates,” she said.

The dangerous illegal and increased use of fentanyl has tragically resulted in additional deaths by overdose, Stout explained said. When prescription opiate availability decreased, people who used opiates turned to heroin as a substitute, opening the door for dangerous fentanyl.

Southern Indiana Community Health Care began exploring MAT treatment options in 2018, when tests showed opiate use among the obstetric population. Initial success of the program promoted SICHC to roll out integrated treatment options to the general public in 2019.

Stout noted that overdoses still tragically occur often. She emphasized that free opioid rescue kits are available without prescription or social contact. Life-saving Naloxone can be administrated by nasal spray or other means in an emergency overdose situation.

“There are many Naloxone Boxes and free distribution points around Indiana,” Stout explained, encouraging any with an opiate issue (or anyone with a family member or friend with an opiate issue) to secure a free, confidential supply at NaloxBoxes around the area. (NaloxBox locations and distribution points can be found at https://www.overdoselifeline.org/naloxone-indiana-distribution/). Several churches, public libraries and facilities, and recovery centers are host to free and accessible opioid rescue kits.

Recovery from substance use takes time and can include complications. In addition to seeking quality medical care, people with substance use are encouraged to take advantage of local peer support groups and 12-step recovery programs like Alcoholics Anonymous and Narcotics Anonymous. Safe Haven Recovery Engagement Center in Orange County offers several options. Interested people can also visit https://www.indianarecoverynetwork.org/

Together with a patient in recovery, Stout presented details about the MAT program and its integrated value during the recent Indiana Rural Health Associations annual state conference in French Lick.