Science and Service Awards
2012 Opioid Treatment Program Winners
New York, New York
Rachel Chernick, LCSW
Over the last several years, the OTP at the Addiction Institute of New York (AINY) has seen a change in the nature of the population they serve. Faced with a greater diversity of patients than ever before, they developed a model of comprehensive treatment with a patient-centered approach. The "Four-Quadrant Model of Opioid Treatment," provides each patient with a menu of options with which to pursue recovery. At admission and throughout treatment, patients can "mix and match" treatments to come up with a plan that best suits their individual situations. The four quadrants are:
- Detoxification Using Methadone;
- Detoxification Using Buprenorphine (quadrants (1) and (2) are followed by psycho-social addiction treatment);
- Maintenance Treatment Using Methadone; and,
- Maintenance Treatment Using Buprenorphine (quadrants (3) and (4) are in conjunction with psycho-social addiction treatment).
In this model, the pharmacotherapy is enhanced by high-quality clinical services including:
- A comprehensive voluntary group program;
- Ongoing nursing and medical treatment;
- Individual psychotherapy, counseling and case management;
- On-site psychiatric treatment; and,
- An Opioid Overdose Prevention Program.
The model is implemented by a respectful and compassionate staff committed to creating a strong therapeutic alliance with patients through the use of a motivational and supportive approach. In summary, this is a unique clinical model that is: medically and clinically innovative; provides excellent patient-centered care; andresults in favorable outcomes that significantly increase patient retention. As the abuse of prescription pain killers increases, the demand for such a model of flexible, patient-centered treatment is highly likely to increase as well.
Katharina Wiest, PhD, MSPH, Director of Research
Established in 1969 as a state agency, CODA was the first in Oregon to provide methadone therapy. Today, CODA offers a wide range of services across 15 programs from inpatient to supported housing including its outpatient opioid treatment program (OTP). The OTP is integrated within the CODA system, allowing each each patient to receive medical and mental health evaluations and referral to appropriate levels of care and recovery support services. The innovative approach adopted by CODA’s OTP is to use the on-site research department to identify needs and trends for this patient population.Using data collected from its electronic medical records to track patient data and trends, CODA can effectively measure and assess patient and program outcomes without needing to wait for information to be published. This allows CODA to modify practices and policies to meet patient needs in real time. Whether it is to identify the increase in non-prescribed opioid abuse in younger women or illicit benzodiazepine rates, CODA’s OTP rapidly adjusts its policies and treatment focuses in response to input from the Research Department. The mission of CODA Research, an independent department within CODA, is to lead, participate in, and support clinical substance abuse research with the goal of improved patient health and outcomes. It is an invaluable asset to CODA’s patients and the greater addictions community. In addition to providing data and guidance to CODA’s OTP, the research department presents at local training seminars, publishes in peer reviewed journals, presents at national and international conferences, and participates in federally and privately funded research endeavors.
Robert C. Lambert, MA, LADC
Kurt Kemmling, CMA
The Norwalk Clinic of Connecticut Counseling Centers, Inc., with the intention of increasing retention rates and improving patient outcomes within their Methadone Maintenance Treatment Program, developed a peer mentoring initiative designed to improve outcomes by improving their patients’ therapeutic alliance with program staff. The goal of the initiative is to create a therapeutic alliance between the patient who is having difficulty stabilizing and the treatment program with the peer mentor being the "bridge" for the alliance. Hence, the program is called "Bridge to Recovery" (BTR). Although the concept of a peer mentoring program is not new, the extensive nature of the training and the specific goal of the mentoring services (enhance the therapeutic alliance) is. The mentors are in long term medication assisted recovery and receive the same three hundred (300) hours of training provided to counselors seeking to become certified addiction counselors. Within this curriculum there is extensive focus on core counseling principles and techniques, including Motivational Interviewing skills. Outcome studies following implementation of this innovation have been extremely positive. The program attributes this success to the specific ability the peer mentors have to address a common reason for premature discharge from treatment: lack of a therapeutic alliance with the treatment program. The BTR program initiative was co-created and developed by both a staff member and a patient, and reflects the patient centered nature of the recovery movement. The BTR has also provided the mentors with a developmental ladder to certification and employment as an addiction counselor.
Last updated: 02/17/2012