Offering Patients Hope

This article has been published with the gracious consent of the Mountrail County Promoter.

You assume that you know the face of opiate addiction. You believe you can tell just by looking at a person, but that is not true. A person is  often struggling in plain sight. It affects all ages and demographics and could be anyone that you know.
Addiction to opioids can happen quickly and easily. Many times, it persists with that person not looking for the “high” but rather just struggling to feel normal. Withdrawal is so profound and so deep that the only way they can get by is to have that opiate on board. They seek it out just to try to have a normal life. It snowballs and takes over their life.
That is where a new program at the Mountrail County Medical Center’s Rural Health Clinic is looking to help. Abbey Ruland, PA and Tammie Braaflat, FNP are offering a MAT Program to help patients looking to move forward and through addiction to a successful and healthy life.
MAT stands for Medication-Assisted Treatment, a strategy for combating opioid use disorders that combines behavioral counseling with prescription medications containing buprenorphine, such a Suboxone.
By the time patients come to them, they say, they are often desperate. They may have lost their job or relationships to the drug addiction. They may have used up their financial resources to get more drugs. They say it is not in an attempt to get high, but rather to take away the horrible pain that comes with the addiction.
Both have taken the required coursework on how to prescribe the medications that will help and credit current CEO Ben Bucher for also having providers on staff in Cando that are part of the MAT programs. They are also working with them with the ECHO Project. Through the University of North Dakota School of Medicine and Health Sciences, the North Dakota Opioid Use Disorder TeleECHO gives providers a virtual learning network with other treatment providers. This program gives collaboration, support and ongoing learning with subject-matter experts and healthcare staff as they look for new ways to support patients in their home communities.
Ruland started her training while still working with Trinity in New Town. She finished that just before returning to practice in Stanley. Braaflat took her training in Bismarck in November and finished the online portion in December. They say that much of the training was in pharmacology and the science of chemical addiction. They learned about the different medications that could be used to treat the addiction and how each works, as well as the side effects and things to watch for during treatment.
It covered how to start the process, known as induction, and the protocols to follow so they do not cause sudden severe withdrawal. It included skills for interviewing and counseling patients. It is about spending the time getting to the bottom of the issue, including the “whys” and “hows” and how to change going forward.
They say it opened their eyes to the differences in the traditional ways to look at addiction and slip ups. Instead it needs to be treated like any other disease. Rather than condemning for a slip up or relapse, instead it is creating open dialog about the ups and downs in the process. It is about not condemning the patient, but rather helping them to avoid those issues in the future. They want to build honest and open relationships to be a pillar of hope for the patient.
Opioid addiction needs to be treated like any other disease. You don’t look at a diabetic and ask why they don’t stop eating or why they don’t just do what is necessary. You work with them. Addiction needs to be treated the same way.
The goal  is to help patients get their lives back on these medications. They want them to be able to regain a sense of normalcy that will allow them to function within their relationships and jobs.
Treatment with MAT will help patients in their own community. In the past patients have had to travel as far away as Bismarck. That is  not realistic if their whole life  then revolves on going that far to get the help they want.
Opioid addiction often starts with a prescription. The addiction happens so fast. For many it is a prescription after a surgery and then the patient finds they can’t go without it. It happens quickly and unexpectedly. It then turns into the need to get more pills, often on the street. It can also turn to a heroin addiction rather than pills because that is cheaper and easier to find.
The buprenorphine works to bind tightly to the receptors while providing no altered sense or euphoria. It allows the patient to get through the painful, profound withdrawal from the opioids.
The MAT program is open to patients ages sixteen and up. The buprenorphine can be used by pregnant patients. It is recognized by all major medical organization. Research shows that this treatment method shows better outcomes. It is not substituting one drug for another, but rather finding a way to help patients reach their goals.
Depending on where the patient is in their addiction and what opiates they are using, they will work with them as they stop and then start the buprenorphine. It is all timed out and dosages will be adjusted as needed. They say that everyone’s story is different, so they are focusing on helping each patient meet their goals. It is not an overnight fix, but they can get there.
It is hope in a hopeless situation. They want their patients to be able to see the light and help them get there. Like any other medical problem, the patient has to have the desire to get better. With open and honest conversation, they can help them get there. They will guide you through this to feel good again. They stress that  they want their patients to know that they are there with compassionate open minds to help. They want them to know they do not need to be scared or ashamed to ask for the help.
Although the program in Stanley has only started in the past few weeks, they already have patients that are benefitting from the program. Opioid addiction is a large issue in Mountrail County, but both are quick to point out that if  you are dealing with it or have a family member dealing with it just losing a single person is a big deal.
They have made sure that the pharmacy is carrying the medication that is dispensed by prescription. At the beginning of treatment, patients will likely be seen twice a week until they are stabilized with their withdrawal and treatment. It will then be based on patient needs, but likely at least monthly.
The length of treatment with buprenorphine will also depend on the patient. For some it could be a lifelong prescription. For others it could be working on a plan to get off it as well once the addiction is treated and their situation changes. That is no different than any other medical diagnosis like diabetes, heart conditions, blood pressure and more that require long-term or lifelong treatments.
You can schedule appointments with either Ruland or Braaflat by calling the clinic at 628-2505. If you are concerned about discussing addiction as the reason for making the appointment, they say that you can tell the scheduler you are looking for medication review or a checkup. They say that discretion is one of their highest priorities as they work towards their goal of wanting people to feel better and find hope for a better future.