A previous NewsLanc interview revealed that effective Suboxone (a.k.a. buprenorphine) treatment for Lancaster’s heroin addicts is largely impeded by a lack of doctors interested in obtaining certification to prescribe this medication. The reason for this reluctance is that, in the words of a local expert, “A lot of physicians really don’t want to … have a caseload of heroin addicts.” To change this pattern of under-treatment, one area organization has set out to make the doctor’s role as simple as possible by independently coordinating the elements of care involved with Suboxone treatment.
The RASE (“Recovery, Advocacy, Service and Empowerment”) Project was conceived in 2002 when Lewistown Hospital created a program to prescribe Suboxone as part of it family practice. It became apparent that there was a need for an agency to assist with the administration of a holistic program to provide for the various supports helpful in bringing about recovery.
By 2007, RASE was all too familiar with the crisis facing Suboxone treatment in Central Pennsylvania. Here is how the RASE website describes the dilemma:
While accessing buprenorphine can be accomplished in the privacy of a physician’s office, there is a responsibility to the patient for referral to appropriate outpatient drug counseling and ongoing referrals to other necessary services that creates a burden on the prescribing physicians. This burden is directly affecting system capacity and physicians are reluctant to take on more buprenorphine patients.
In 2007, the Health Choices Initiative in Dauphin, Cumberland/Perry, Lancaster, and Lebanon counties recruited RASE to create a buprenorphine coordinator program for the five-county area. Assistant Director Dona Dmitrovic described the program as “coordination of care”—an effort to streamline all of the channels of service that Suboxone treatment entails. Dmitrovic explained the process:
“A person will call, say, Center City [Clinic] down in Lancaster and say, ‘I want to get in the Suboxone clinic.’ [The clinic] will say, ‘Okay, you need to call the RASE Project.’ They’ll call the RASE Project, our coordinator will take all of the information, we’ll fill out all of the paperwork, we make the doctor’s appointment, we meet them at the first doctor’s appointment, and then we make an appointment for them to go to outpatient counseling.”
Through this program, RASE now serves a monthly average of 175-200 patients, and a yearly average of 350.
RASE can also work with patients to obtain to housing, medical, or transportation assistance, when necessary. The ultimate goal of RASE’s buprenorphine coordinator program is to improve the caliber of service provided to local addicts and to increase the number of doctors that are willing to provide it. After two years of running the program, Dmitrovic said, “I think we’ve gotten some doctors on board that, in the past, would not have done this without the help of our program.”
The buprenorphine program, which runs both in Harrisburg and Lancaster (LGH Wellness Center, 2100 Harrisburg Pike), finds most of its clients in Lancaster County. According to Dmitrovic, future plans may include shifting more operations to the Lancaster area to better serve in the population of highest need. And, ideally, Dmitrovic hopes to see a service created in Lancaster where all of the elements of buprenorphine treatment are unified in a central location: “We would love to do a one-stop shop kind of thing where people can come and get all of their needs met.”
A working relationship is already being discussed between Lancaster General Hospital and RASE.
For more information about the RASE Project and its buprenorphine coordinator program, click here.
