This past summer the Lamoille Valley MAT (Medication Assisted Treatment) Team garnered local and statewide attention for their opiate addiction treatment program, implemented at CHSLV’s Behavioral Health and Wellness, Morrisville Family Health Care, and Stowe Family Practice, as well as other medical practices in Lamoille County. They are one of the only MAT teams in Vermont utilizing a relatively new drug called Vivitrol, an injectable form of the medication naltrexone. Oral naltrexone has been used since the 1980s to help alcoholics. In 2010 the FDA approved it for treating opiate addiction. Studies have shown it may be a good alternative to methadone and buprenorphine for people who are truly ready to be in recovery from opiate addiction.
The Lamoille County MAT Team is integrated with family practices, so they are able to offer Vivitrol injections in a medical office. “It’s very cooperative and collaborative,” says Medical Social Worker Dawn Palladino, a MAT Team member who works at Morrisville Family Health Care. “The doctors don’t have time to be addiction treatment specialists, but they do the medical part of prescribing medications and giving the Vivitrol injections, and they often ask us for our opinions on patient progress.”
Currently there are about 10 patients in Lamoille County’s MAT Team program taking Vivitrol, and it appears they are having life-changing experiences. None are reporting opioid cravings or relapses while in the program. Vivitrol requires that patients be completely detoxed from opiates for 7 to 10 days and inducted with the oral form first. If they tolerate it they switch to the monthly Vivitrol injection.
But it’s not just about getting a shot. MAT patients are required to attend intensive counseling. “Many patients with substance abuse disorders are using opiates to self medicate,” says Psychiatric Nurse Practitioner Jessica Terrien. “I try to help them figure out what has led them to this place and help them not use. The MAT Team has done a great job of integrating systems that are already in place. They are the glue that pulls people in and keeps them accountable.”
Because of their innovative work, the MAT Team has made numerous public appearances:
On July 17, WCAX did a story about Vivitrol. They wanted to visit a site that was implementing Vivitrol and chose Stowe Family Practice. They interviewed Dr. Katie Marvin and MAT RN Katie Whitaker, and filmed one of their patients receiving his Vivitrol injection. “It was really impressive and compelling that our patient was willing to be profiled. He talked about how he had lost everything, but with Vivitrol he was able to begin turning his life around,” Whitaker says.
State House Presentation
In response to the interview on WCAX, MAT RN Katie Whitaker and Dr. Marvin were invited by Barbara Cimaglio, Deputy Commissioner, Alcohol and Drug Abuse Programs and Hal Cohen Secretary of Health and Human Services to present their findings on the Vivitrol program at the State Offices in Waterbury, in hopes of implementing Vivitrol in other areas of Vermont. Earlier this year Dr. Marvin and Whitaker also presented on
Vivitrol at a learning collaborative sponsored by Vermont Blueprint for Health, and have been asked to present again at the Office Based Opiate Treatment 101 Learning Collaborative in the fall.
In June, a community forum on opiate addiction was held at Green Mountain Technology and Career Center in Hyde Park. Dr. Marvin and the MAT Team joined Dr. Betsy Perez of Copley Hospital and Lamoille County Sheriff Roger Marcoux in a discussion about opiate addiction. The meeting was well attended by community members, parents, police officers, state representatives, and the general public. “It was a great time to really network within the community to start to address the overwhelming opiate problem that we have here.” Whitaker stated.
Dr. Marvin is supportive of the MAT Team and the Vivatrol program, but would like to see more work being done on prevention. “Prevention needs to be discussed more. Doctors need to decrease the number of prescriptions for pain medications, with fewer pills per prescription, and we need to reduce the number of first-time users,” Marvin says. “And we need more safe places and public spaces in the community where kids can socialize in a drug-free environment.”
Lamoille County’s MAT team consists of Katie Whitaker, MAT RN, CADT, who works primarily at Stowe Family Practice with Dr. Katie Marvin and Dr. Melissa Volansky, as well as with Psychiatric Nurse Practitioner Jessica Terrien; Arie Schue, MAT RN, MAEd, CADT, who works with Treatment Associates and with Psychiatric Nurse Practitioner Alexander Johnston at BHWC; and Dawn Palladino, MSW, AAP, who works with Dr. Rossman and at Morrisville Family Health Care with Dr. Kim Bruno and Dr. Phil Kiely. For more information about CHSLV’s MAT team call 802-888-6009.