With substance use disorder affecting thousands of West
Virginians and their families, access to treatment continues to be
a necessity. Unfortunately, the treatment landscape is complex
and can be challenging to navigate.
“There’s a broad continuum of care available, but when
we say treatment, it gets very confusing because there are a
lot of different types of treatment. This includes clinical and
peer-based services,” says Frankie Tack, clinical assistant
professor and coordinator of the addiction studies program at
West Virginia University. “On the peer support side, we have
12-step-based programs as well as peer recovery coaches and
specialists. Those aren’t treatments, though—those are peer-
based support group models. The clinical side has a continuum of
services and levels of care that become increasingly intensive.”
There is not a one-size-fits-all solution for treating substance
use order.
“The most effective form of recovery or treatment is the one
that works for the individual,” says Reggie Jones, executive
director of Recovery Point West Virginia, a nonprofit organi-
zation offering recovery services at no cost to clients. “Some
people need multiple attempts to find the program that works
for them, such as abstinence-based, medication-assisted or
religious. It is all about finding the right fit for the individual.”
Like with many health issues, there are a variety of factors
that determine which treatment will be the most effective for
an individual, according to Christina Mullins, commissioner of
the West Virginia Department of Health & Human Resources’
(DHHR) Bureau for Behavioral Health.
“For example, an individual who has a cold might choose to
take medicine to address the symptoms or decide to get more
sleep to improve their health, but an individual with other
serious health problems such as a compromised immune system
who gets a cold might be advised to go immediately to the
hospital,” she says.
“The most effective form of recovery
or treatment is the one that works
for the individual. Some people
need multiple attempts to find the
program that works for them, such
as abstinence-based, medication-
assisted or religious. It is all about
finding the right fit for the individual.”
“Medications approved by the Food and Drug Administration
(FDA) for treating opioid use disorders help reduce cravings
and withdrawal symptoms and allow the individual to focus
on recovery, work, education and family,” says Mullins. “The
medications that are approved by the FDA for opioid use
disorders are methadone, buprenorphine and naltrexone.
Research indicates that 12 months of MAT is believed to be
the minimum needed for effective treatment.”
Medications used as part of MAT are highly regulated at
the federal level, and additional regulations have been enacted
by the West Virginia Legislature. These include requiring
medical offices to register with and follow the DHHR’s Office
of Health Facility Licensure & Certification oversight as well
as organizational, programmatic and clinical requirements. For
example, methadone must be prescribed through a regulated
opioid treatment program, and the DHHR has limited the
number of these programs to nine in the state.
Medication to treat substance use other than opioid substance
use is more limited, although it does exist for some alcohol
and tobacco use disorders.
Medication-Assisted Treatment
For opioid disorders, evidence from the American Society of
Addiction Medicine and The Pew Charitable Trusts supports
the use of medication-assisted treatment (MAT). MAT combines
psychosocial needs assessment, supportive counseling, links to
existing family supports and referrals to community services
with medication. It is offered in both inpatient and outpatient
settings.
Public Behavioral Health Services
Broadly, West Virginia’s publicly funded community-based
behavioral health system is anchored by 13 comprehensive
behavioral health centers operating full service and/or satellite
offices. Public behavioral health services provided by these
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