QRT pharmacist thinks drive-through gives people privacy
It’s one of the few silver linings that has emerged during the COVID-19 pandemic: The rise in medication assisted treatment (MAT) for individuals looking for help with substance use disorders.
That’s what Michael LeMasters, pharmacist at Pierpont Landing Pharmacy and a member of the Monongalia County Quick Response Team, has observed.
“One of the factors that has changed in pharmacy with COVID-19 was that, to increase social distancing, we went to drive-thru only,” LeMasters said. “That model seems to increase the number of individuals who want to talk about their medications, specifically medications that relate to medication assisted treatment.”
“The only thing I could think of was that patients felt the drive through increased their privacy,” he added. “They didn’t have to get out of their vehicle or have other patients around them. The drive through appeared to give more privacy and in turn, that encouraged patients to open up more about treatment.”
MAT combines behavioral therapy that individuals can receive for opioid use disorder with medications that will help ease withdrawal symptoms and psychological cravings that can occur when an individual quits taking opioids, according to the Substance Abuse and Mental Health Services Administration (SAMHSA). These medications include methadone, buprenorphine and naltrexone.
As a member of the Monongalia County QRT, LeMasters has seen his patient caseload of those entering MAT programs increase via referrals from peer recovery coaches (PRCs). As fellow QRT members, PRCs get overdose reports from MECCA 911, law enforcement and EMS sources with a goal of finding individuals who overdosed within 24-72 hours to get them into treatment.
Treatment could be a variety of options, including an in-patient rehabilitation center, a 12-step program, a sober living house, etc. MAT can be coupled with those behavioral therapy practices.
In fact, one new patient of LeMasters’ was a referral from Dan McCawley, program manager for WV PEERS and a member of the QRT, which was organized in 2019 by Monongalia County Health Department. The individual was having trouble getting a MAT prescription filled, until he learned about LeMasters and Pierpont Landing Pharmacy via McCawley.
“Some of our patients have had a very difficult time, to say the least, dealing with feelings of isolation and loneliness brought on by the pandemic,” McCawley said. “It’s often said that isolation is at the core of the disease of addiction. That, coupled with the inability to connect in person to lifesaving programs like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), has had a profoundly negative impact on individuals struggling with substance use disorder.”
The Monongalia County QRT began meeting weekly in May 2019 with the support of a $230,000 grant from the West Virginia Department of Health and Human Resources, Office of Maternal, Child and Family Health awarded to Monongalia County Health Department. In addition to LeMasters, McCawley and McCawley’s fellow PRCs, members include health department staff, law enforcement, EMS, MECCA 911, faith organizations and others.
Earlier this year, MCHD received a grant, once again distributed through the state DHHR, that will allow the QRT to operate at least through August 2022. These funds come from an Overdose Data to Action grant (cdc.gov/drugoverdose/od2a/index.html) through the Centers for Disease Control and Prevention.
The PRCs can also help connect individuals to services, such as housing, help with utilities, and/or naloxone, a drug that reverses the effects of an opioid overdose.
However, the pandemic has caused roadblocks for the QRT, which is still meeting weekly via Zoom.
For instance, for about two months, PRCs only connected with people via Doxy.me, a telehealth site.
“The daily utilization of a telehealth platform still allowed face-to-face interactions and increased our reach, in real time and moments of crisis, to rural and isolated community members,” McCawley said.
Coincidentally, John Hitchens, chief of EMS of Star City Fire & EMS and a member of the Monongalia County QRT, just completed his master’s in business administration (MBA) in health care management at Colorado Technical University. He did his master’s thesis on telehealth in emergency medical services.
And while he agrees with McCawley that person-to-person contact is sometimes ideal, he noted that telehealth provides a great option in many circumstances.
“By utilizing telehealth, peer recovery coaches were able to continue their mission during the pandemic,” Hitchens said. “Intervention, support and positive reinforcement on any level is better than none at all to support those requiring and seeking assistance with addiction during a global pandemic.”
LeMasters said that not only has the drive-through deepened conversations with existing patients, but he believes it has helped add new ones during the pandemic.
“We did have patients who showed up and commented that they liked the drive-through service,” LeMasters said. “They said it made things easier when getting medication.”
As businesses open up, patients are allowed back in the pharmacy now, but LeMasters believes that some will keep using the drive-through.
“I would encourage people to come see us regardless, whether it’s a walk-in or a drive-through. But I feel like a lot of MAT patients will continue to use the drive-through now that they’ve seen the ease of using it.”
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