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SAMHSA News - March/April 2004, Volume 12, Number 2

In Action: One Community's Story

a farm in Lewistown, PennsylvaniaNestled in central Pennsylvania, Lewistown used to be the kind of place where people didn't lock their doors. That changed when gangs brought heroin to town a couple of years ago. This rural area was faced with a violent crime wave and a surge in addiction among teenagers and young adults.

Lewistown started a grassroots effort to solve this problem. Working as a team, a local hospital, a family health practice, and a substance abuse treatment center developed an innovative protocol for providing buprenorphine treatment. The team announced the new option's availability during a "community day." Members held a press conference at the local hospital and immediately started accepting patients.

Sally Wooten, M.D., prescribing physician and Cheryl Stayton, Ph.D. Buprenorphine Program Coordinator and psychologist 
Brad Miller, D.O., prescribing physician Members of the Buprenorphine Model Program at Lewistown Hospital's Family Health Associates include (top left) Sally Wooten, M.D., prescribing physician; (top right) Cheryl Stayton, Ph.D., Buprenorphine Program Coordinator and psychologist; and (bottom) Brad Miller, D.O., prescribing physician.

While law enforcement targeted the gangs, local health care providers tackled the addictions. Local physicians received special buprenorphine training sponsored by the American Society of Addiction Medicine and funded by SAMHSA's Center for Substance Abuse Treatment (CSAT) as part of an initiative to educate physicians throughout the Nation (SAMHSA News, Training Physicians).

The Lewistown program proved so successful, according to CSAT senior public health analyst Nick Reuter, M.P.H., that CSAT sent a team to Lewistown in November to see how the program operated, visit with doctors and patients, and hear about local law enforcement efforts and treatment options. The team included Arlene Stanton, Ph.D., a social science analyst, and Ruth Hurtado, a public health advisor.

What's special about the Lewistown approach, said Mr. Reuter, is its use of a coordinator—a psychologist, in this instance—to handle much of the time-intensive interaction and followup required during the treatment's early phase.

"This model addresses two major concerns related to providing buprenorphine treatment," added Dr. Stanton, "First, it allows medical doctors to 'do business as usual.' That means it relieves doctors of time-consuming startup procedures for their patients on this treatment. Second, it ensures these patients receive integrated care—both medical and psychosocial."

In Lewistown, the psychologist meets with patients and their families to educate them about buprenorphine and do some preliminary assessments before they see a physician. After a patient's initial dose of the medication, she checks in to offer reassurance and see if dose adjustments are needed. Later she makes sure patients are going to counseling appointments and complying with the treatment regimens.

Without this kind of help, these physicians admit that taking on more than a few patients at a time would be impossible.

With the nearest methadone clinic located hours away, the use of buprenorphine has been a boon for this rural community, and it offers the same potential for other underserved areas.

In Lewistown today, four physicians are prescribing buprenorphine to their patients. Joe,* 25, is one of these patients. Trying to get his heroin and other addictions under control has not been easy, but after years of addiction, he found his cravings began to subside when he started buprenorphine medication. "By the time the psychologist called him the night after his first pill, he was already thinking more clearly," said Dr. Stanton, who sat in on the young man's induction. "Now he is eager to begin his new life." End of Article


« See Part 1: SAMHSA Helps Bring Buprenorphine to the Field

« See Part 2: SAMHSA Helps Bring Buprenorphine to the Field

See Also Buprenorphine-Related Content:

« From the Administrator: How Is Buprenorphine
Treatment Working?

« Resources

« Training Available for Counselors

See Also—Next Article »

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Inside This Issue

SAMHSA Helps Bring Buprenorphine to the Field
  • Part 1
  • Part 2
    Buprenorphine-Related Content:
  • From the Administrator: How Is Buprenorphine Treatment Working?
  • Resources
  • Training Available for Counselors
  • In Action: One Community's Story

    President's 2005 Budget Proposes Increase for SAMHSA Services
    Related Content:  
  • SAMHSA Budget Authority by Activity

    SAMHSA News Gets a New Web Address

    Majority of Youth Say Marijuana Easy To Obtain
    Related Content:  
  • By Gender, Percentages of Youth Reporting that Obtaining Illicit Drugs Is Easy: 2002
  • By Age, Percentages of Youth Reporting that Obtaining Illicit Drugs Is Easy: 2002

    On the Web: A New Resource for Child Traumatic Stress

    Methadone From Clinics Is Not the Culprit

    SAMHSA Adds Sixth Accreditation Body for Methadone Programs

    Retailers Reduce Cigarette Sales to Youth
    Related Content:  
  • Retailer Violation Rates Reported in 2002

    Treatment Admissions Rise for Narcotic Painkillers
    Related Content:  
  • Rates of Narcotic Painkiller Admissions by State

    SAMHSA News

    SAMHSA News - March/April 2004, Volume 12, Number 2

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