UK HealthCare SMART Clinic

Transcription:

Prakash Chandran (Host): Addiction. It's a disease that we hear about all the time. If we ourselves aren't affected by it, we likely know someone who is. At UK Healthcare, there's a recovery program called Supportive Mental Health and Addiction Recovery Treatment, better known as the SMART Clinic Program. We're going to talk about it today with co-directors Dr. James Hawthorne, Medical Director and Gray Manus, Licensed Clinical Social Worker and Licensed Clinical Alcohol and Drug Counselor for the UK Healthcare SMART Clinic Program and the Department of Psychiatry, another informational resource from UK Healthcare. This is UK Health Cast featuring conversations with our physicians and other healthcare providers.

I'm your host Prakash Chandran. So Gray and Dr. Hawthorne really great to have you here today. Really appreciate your time. Gray, I'd love for you to start by telling us what exactly is the SMART Clinic?

Gray Manis, LCSW (Guest): Yes, the SMART clinic. Actually the word SMART is an acronym for supportive mental health and addiction recovery, and treatment. And at the SMART Clinic, we provide innovative and comprehensive addiction treatment and trauma informed psychiatric services to people that have substance use disorders who may also have co-occurring disorders. And we do this in an outpatient healthcare setting where they can also get their primary care needs met. So we offer really a variety of different services that include medication for opioid use disorders and that would include Suboxone and Vivitrol. We also offer psychiatric care for folks who have other mental health disorders in addition to their substance use disorders, we offer a SMART parenting track for postpartum women.

We do treatment for alcohol and other substance use disorders. And do that with both group and individual therapy. We really emphasize the need to treat trauma because many of the folks who have substance use disorders have histories of trauma. And we also offer targeted case management and peer support as well as primary health care, which would include treatment for hepatitis C.

Host: So Dr. Hawthorne, Gray just covered an overview of the SMART Clinic and some of the services offered there. But at a high level, can you just speak to how this benefits the community?

James Hawthorne, MD (Guest): Sure. I mean, I think, you know, many people are aware that addiction is a big problem in Kentucky. You know, especially with the opioid epidemic, it's been very disruptive to the communities, you know, that we work with. People who have known someone who's had a substance use problem. They've experienced substance use problems themselves. Unfortunately many people know someone who's, who may have passed away from addiction or complications of addiction. And so, you know, what we're trying to do here is you know, offer comprehensive outpatient treatment for substance use disorders. And as Gray described, you know, that includes not only management and treatment for the addiction itself, but also for, you know, co-occurring mental health conditions, co-occurring physical health problems.

You know, so we're, we're really trying to do our part, you know, as to be one piece of the puzzle to, to address, you know, really what is a big societal problem in Kentucky between an opioid addiction, alcohol addiction, cocaine, methamphetamines, all of these things have been very disruptive and we are trying to do what we can to address these things in an outpatient treatment setting.

Host: So Gray, can you specifically speak to the types of conditions that are treated there?

Gray: Yes. You know, we, we treat all in any substance use disorders, of course with what James just referenced as the opioid epidemic. So I would say the majority of our patients thus far have had opioid use disorders, but certainly a huge problem as well with methamphetamine and alcohol use disorders. And any other substance use disorder such as with cannabis or benzodiazepines or even nicotine. We can help anyone that has a problem with any of those addictions as well as treating any mental health disorders that they may have as well. Co-occurring disorders such as PTSD, depression, anxiety, bipolar disorder, obsessive compulsive disorder, or any other types of mental health disorders. So, and as well, I also mentioned that we have the capability to do primary health care here.

And we are also going to be treating folks who have hepatitis C. So we're really offering integrated care model where when someone comes to the clinic, primarily with a substance use disorder, they can have all these other problems addressed as well.

Host: Now Dr. Hawthorne, Gray kind of started alluding to this with the integrated care model, but I know that oftentimes it takes a multidisciplinary group of people to help a patient, you know, improve or get better. So can you describe the care team a patient has when they're seen at the SMART Clinic?

Dr. Hawthorne: Absolutely. And you're right. I think you know, mental health care generally and definitely substance use treatment is best when it's multidisciplinary and there's a comprehensive care team. So that's what we try and do here. You know, when patients come to the clinic, there'll be a careful assessment of what they need.

And you know, we have a lot of things we can offer them, but typically a patient's care team would include it would be, you know, possibly prescribing medication assisted treatment for an addiction, who may be prescribing psychiatric medications for you know, co-occurring mental health conditions or be prescribing medications or offering other treatments for physical health problems.

The care team would also include a therapist who would maybe work with the patient individually or in group, depending on the exact needs of the patient. Patients would also have a social worker who would and be able to do case management if needed and a peer support specialist who would meet with them regularly to help guide them through what can be a pretty complicated process of recovery and a complicated system of care.

You know, when patients are trying to navigate treatment for substance use disorders, things that you know are available, you know, if needed would be a pharmacist who can work with patients who are on complicated medication regimen. And so there really is a breadth of different providers and staff available to work with patients and ensure that all of their needs are addressed.

Host: So Gray in doing some research for this, I came across the parenting program at the SMART Clinic. Can you explain what this is?

Gray: It's really an outpatient substance use disorder treatment program for postpartum and parenting women. And so it's within the SMART Clinic. So, these patients are getting the same services as everyone else, or have access to the same services as everyone else, including you know, medication treatment with for opioid use disorder, as well as psychiatric care, individual and group therapy.

But in addition to that, because they are postpartum women, they're getting parenting education and support, access to domestic violence groups. And there's just more of a focus on supporting them as they parent their children, and at the same time deal with their addiction and get into recovery and anything to add to that, James?

Dr. Hawthorne: Yeah, sure. So yeah, this is a program that has existed for a while. And as, has recently sort of joined forces and become part of the SMART Clinic within the last year. And it's a unique set of challenges, when, you know, a woman is trying to parent a child or trying to regain custody of a child and is struggling with a substance use disorder.

And so we've got a group of staff and providers who are really experienced in working with that population and helping guide them through what can be a confusing and overwhelming kind of process. Often there's involvement of the courts or DCBS. Or complicated situations surrounding custody that are tricky to navigate and very stressful for women as they try and work on their own recovery.

So it's still sort of part of the same clinic here and all the same services are available, but there's a special emphasis and focus in, in that track within our clinic to assist these women as much as possible.

Host: Yeah, I think it is wonderful, that there is specialized attention for a unique time in a woman's life, because there's just so much going on. And I think that's potentially one of the things that separates the SMART Clinic from other substance abuse treatment facilities. But that's actually something that I wanted to ask. So Dr. Hawthorne, you know, there are so many facilities that might be out there to treat some of the conditions that we're discussing today, but I'm curious as to what you feel makes the SMART Clinic unique and different.

Dr. Hawthorne: Yeah, you're right. I mean, there are a lot of clinics out there that prescribe suboxone for treatment of opioid use disorder. And we do that and you know, that can be an effective treatment, but I think the thing that, or maybe the things that separate us from those other clinics would be sort of the really comprehensive nature of the treatment we're offering because not only are we prescribing medications like suboxone for treatment of opioid use disorder, but we're really trying to address holistically, you know, a patient's health and assist them in a multifaceted way in their recovery. You know, so to that end we're offering psychiatric services, you know, with psych individual and group psychotherapy all in a trauma informed care model.

And like you pointed out too, we do have a specialized treatment for parenting women, you know, so we have a special things that we offer in terms of providers and who have experience with working with that population and in specialized content of the treatment for those parenting women as well. So, so the, really the focus on treating not just addiction, but underlying mental health problems, underlying trauma, offering specialized treatment to women who are parenting you know, and struggling with a substance use disorder. Those are the things I think that set us apart the most.

And additionally to that additional benefit, I think that we can offer would be as Gray has mentioned the primary care services and treatment of hepatitis C here in, within the same program.

Host: So Gray, I wanted to move on to you. You know, there, there might be someone that is listening to this that needs help and is thinking about coming to the SMART Clinic. But there's just a lot of unknown and maybe apprehension around what the experience is going to be like. So could you speak to what a patient should expect at their initial appointment?

Gray: Sure. I, and I kind of want to back up just for a moment. I think just from the moment that they make the phone call to our clinic for an intake, they will speak with someone who will get information from them and based on that information, they will determine who they need to see, which, because we do have, you know, different tracks, you know, if they need to be in the parenting women track for instance, or if they need to be in a regular SMART Clinic track for medication for opioid use disorder track, they also could say that they really have an alcohol problem.

They don't need to be in either one of those. So this person that they speak with on the phone is going to determine who they need to see and then for their initial appointment and when they come in, they will meet with either a physician or a nurse practitioner, as well as a social worker who will then do a comprehensive assessment and determine what the next steps will be for them. James, do you have anything to add to that? Am I leaving out there?

Dr. Hawthorne: I think the main point is you meet with the core members of your team, your care team during your first visit. And they will meet with you as a patient and take a detailed history, really get to know you and try and figure out how best we can help you. And so, just like Gray was saying, I mean, that would be a provider, either a physician or a nurse practitioner and a social worker.

You know, so there is emphasis on understanding your substance use problem, understanding any kind of mental health problems you might have, in addition to that, any kind of physical health needs, you might have, any sort of social needs that, you know, need to be addressed. And so you really come out of that first appointment with the, with a, hopefully a good understanding of what the treatment plan should be going forward to help you get back on track.

Host: And Dr. Hawthorne, how exactly does a patient actually go about scheduling an appointment?

Dr. Hawthorne: So the best thing for the patient to do would just be to call the clinic. And the direct line for the SMART Clinic is is available on the website, but it's I can also give that here. It'd be 859-562-2356. And when you make that phone call, just be prepared to, you know, tell us a little bit over the phone about what sorts of problems you've been having with a substance use disorder and how, and what sorts of treatment you think you might be looking for so that we can, we can know best within our program here, who to have you see for your initial appointment.

As Gray mentioned, there's the parenting women track, there's the medications for opioid use disorder track, there's other treatment options available for people who do not have opioid use disorder, but are seeking treatment for alcohol or cocaine or methamphetamine addiction. But you know, obviously we're not going to do an entire assessment over the phone. That wouldn't be a good use of anyone's time. And the most important thing would just be to be prepared to tell us a little bit about what you're seeking in terms of treatment for substance use disorders and that we can guide you then within our program to the appropriate track so that we can set up your initial appointment to be as helpful as it could possibly be.

Host: So Gray, just as we start to close here, it seems like there's just a lot that the SMART Clinic has to offer. We've talked about the multidisciplinary team, we've talked about the different tracks. What kinds of other health resources do patients have access to when they're at SMART?

Gray: Well, because we really offer an integrated care model, we really offer any kind of service that can treat the whole person. So if for instance, they come in and they've got, they may be addicted to opiates. But they also as many of our patients would say, have not been to see a primary care physician in many years, because they've been completely, you know, engrossed in their addiction. Because their life has been completely ruled by their addiction for so long, they have not seen a primary care physician in many years. We offer that. We offer them primary care an opportunity to see a physician who could best assess what their healthcare needs are.

We also offer psychiatric care. And I would say the majority of the folks that come to our clinic with a substance use disorder also have a co-occurring disorder, such as depression or anxiety, a lot of PTSD. That's something that we can also treat with medications and with trauma-informed therapies.

We also have mentioned targeted case management. So if someone needs to have a case manager work with them on an overall plan for their treatment, their healthcare, helping them get on track with employment, finances, things like that we have someone that can do that with them, and we also have peer support specialists who can just be there for not only motivational support, but support for their recovery. And if they just need someone to talk to, they're having a difficult time. So we feel like we cover all the different we cover a lot of different areas in a person's life with different services that we offer here. And that's really what sets us apart. We really, truly are a one-stop shop for everything for someone with a substance use disorder,

Host: So final question. And this is to both of you and Dr. Hawthorne, I'll start with you. Is there anything else you'd like for a potential patient or family member to know before we close here today?

Dr. Hawthorne: Well, I guess I would just say that you know, addiction can be an overwhelming problem or a problem that seems overwhelming and a system of care for getting treatment for addiction and all the things that go along with it is can be complex and kind of hard to figure out your way through.

So what we're trying to offer you here, I think, is a place where you can get a lot of the needs related to treatment of your substance use problem met all in one place. So, if you feel like you're ready, you know, to take the next step in recovery and or maybe the first step in recovery you know, we are here to help and we'd like to hear from you.

Host: And Gray, I'll let you have the final word.

Gray: Yeah, I would just say that we realize here that making that phone call, it can be pretty frightening for some people to reach out for help. And they may have come to a point of desperation when they're willing to make that phone call and ask for help. We realize how hard that is and how scary that can be. And you know, we welcome folks who are desperate. We welcome folks who are hurting and have just been ravaged by addiction. And we are excited about helping people to take their life back because ultimately that's what we want to do here. We want to help people take their life back and you know, have the best quality of life they can in recovery.

Host: Well Gray and Dr. Hawthorne, this has been a wonderful and informative conversation. Thank you both so much for your time.

Gray: Thank you.

Dr. Hawthorne: Yeah, thank you very much.

Host: That was Co-Directors Dr. James Hawthorne, a Medical Director, and Gray Manis, Licensed Clinical Social Worker and Licensed Clinical Alcohol and Drug Counselor for the UK Healthcare SMART Clinic Program and the Department of Psychiatry. And that wraps up another episode of UK Health Cast with the University of Kentucky Health Care. To find out more information about our program or to speak to a SMART Clinic Specialist, you can call 859-562-2356.

If you found this podcast to be helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. My name is Prakash Chandran. Thank you so much for listening and we'll talk next time.