GEORGETOWN — Atlantic Family Physicians, based in Georgetown, is planning to expand access to lifesaving medication for more than 100 patients with opioid use disorder this year, according to information from the Delaware Division of Health and Social Services.
A federal grant provided through the Division of Substance Abuse and Mental Health in response to the state’s opioid epidemic has helped with the expansion. The practice currently has 12 patients on medication for opiate use disorder and two full-time nurse practitioners have been hired to help provide treatment for additional patients.
Dr. Fabricio Alarcon, the head of the practice who is board certified in addiction medicine, began treating patients with opiate use disorder years ago, but said he’s now focused on integrating medication-assisted treatment into the primary care office setting. Dr. Alarcon was inspired by the use of medication-assisted treatment for opiate use disorder eight years ago when he filled in as the medical director for a nearby outpatient treatment center.
“I loved that helping patients stay sober could change their lives,” Dr. Alarcon said. “I’ve seen marriages be saved, and families get stronger when people get treatment.”
The Atlantic Family Physicians initiative is one of 56 sub-grant applications currently received by the Division of Substance Abuse and Mental Health for State Opioid Response funding.
In addition, 37 of the applications are focused on helping a variety of health care programs screen existing patients for opioid use disorder. A federal grant brought in $37 million in discretionary funds for the state to expand opioid and stimulant use treatment and overdose prevention initiatives.
Joanna Champney, director of the Division of Substance Abuse and Mental Health, said it is critical for the state to expand the number of treatment providers in Sussex County as it not only ranks high for overdoses but it also has transportation challenges due to its rural setting. This has been a major focus of the Overdose System of Care Committee, which Ms. Champney co-chairs with Dr. Rick Hong, medical director of the Delaware Division of Public Health.
“Rural areas are particularly vulnerable because people are isolated,” Ms. Champney said. “They can’t get to treatment as easily, and there are fewer providers to choose from.”
Atlantic Family Physicians is coordinating transportation for its patients in need to increase access to medication for opiate use disorder. The frequency of office visits varies based on the specific medication of a patient. Patients begin by coming in weekly and office visits can later be spaced out if improvements are made, as most patients end up coming in once a month.
Patients who are coming out of active addiction typically are prescribed buprenorphine, according to Dr. Alarcon. Those who may be coming out of an inpatient or outpatient treatment program can be prescribed Vivitrol, especially if they are also using alcohol, DHSS said.
Patients who stop treatment too early often struggle to manage their cravings and are at higher risk to relapse, according to Dr. Alarcon.
Dr. Alarcon added the practice hopes to address the high number of patients who leave emergency departments after a non-fatal overdose, but never show up to start treatment. His dream is to offer 24-hour intake, meaning patients could be brought to his practice anytime, day or night, after leaving an emergency department, to begin treatment for their opioid use disorder. Dr. Alarcon is already always on call, seeing patients on a flexible schedule, with no set time windows.
“We are here,” Dr. Alarcon said. “We are willing to help people not only get sober, but to get their lives back together.”
The state’s Bridge Clinics, which are operated by the Division of Substance Abuse and Mental Health, are also partially funded with the federal grant funds. Three Bridge Clinics statewide, one in each county, see walk-in clients, at no cost, for any type of mental health or substance use disorder. Clients are evaluated promptly and a connection to a longer-term treatment plan is arranged.
Last year, there were 447 fatal drug overdoses in the state, with 122 in Sussex County.
Those struggling with substance use are encouraged to call the Delaware Hope Line at 1-833-9-HOPEDE or to text CONNECT to 55753.