The county health department building on Scholls Lane is inconspicuous, but it now houses a program one Baltimore-based company hopes can help in the fight against Frederick County’s opioid epidemic.
Concerted Care Group took over the health department’s Project 103 outpatient methadone clinic at the end of last year. They’ve created a new program and they’re trying to help more Frederick County patients than ever before through comprehensive, medication-assisted treatment.
“We want to build and grow from where 103 was,” center director Joshua Prasad said. “We want to provide that comprehensive package of care that you won’t find elsewhere.”
CCG brings an integrative health care approach to treating opioid-use disorder. In addition to supervised administration of methadone, buprenorphine and other opioid dependency medications, the clinic provides primary health care, mental health counseling and social services.
CCG President Dr. Andrey Ostrovsky said that his group looks at the person as a whole and wants, “To get people into sustained recovery, where they are developing the coping mechanisms and getting all the upstream health determinants,” he said. “We help them with the primary care, with the social services to get into sustained recovery to help them meet their personal goals.”
CCG won a competitive bidding process for the outpatient treatment clinic in 2017, The News-Post previously reported. The Behavioral Health Administration within the Maryland Department of Health had made money available for local health departments seeking to expand drug treatment services.
Ostrovsky was hired as president and CEO of CCG after they won the bid for the Frederick clinic. He is a former chief medical officer for the federal Center for Medicaid and CHIP Services.
So far, CCG is treating about 150 patients daily, according to Prasad, including some former Project 103 patients. The priority for the clinic is to increase the number of people they serve.
“We’re out in the community. We’re talking to people. We’re doing what we can with our fellow providers in the community, with local social service agencies, with street outreach, with people who might be ready to go into recovery right now — to hopefully get people into the care that they need,” Prasad said.
New patients are given a series of evaluations to assess their needs, including but not limited to physical and psychological issues.
“We do a very comprehensive assessment, to ensure that we can provide the most robust amount of services,” Prasad said. “Ideally, within a couple hours, before they start feeling withdrawal effects, they can be assessed and start with their medication-assisted treatment.”
Medication-assisted treatment is strictly regulated. It involves methadone, buprenorphine, or naltrexone, drugs that to varying degrees block the receptors in the brain and have similar effects as other opioids.
Stigma around medication-assisted treatment is common. Politicians often oppose the approach to addiction treatment because it appears to just replace one drug with another.
But according to CCG, data shows getting methadone or buprenorphine, even without other medical and mental health services, improves recovery outcome and community conditions.
“Busting your elbow through a car window to steal 10 bucks to buy heroin on the corner to inject is a very different outcome than coming to a clinic, medically supervised with all the support,” Ostrovsky said.
A CCG nurse makes sure patients aren’t taking their medication in combination with other drugs and observes them after administration.
The clinic is open Monday through Saturday. Patients are given their Sunday dose to take home and can earn more take-home doses by staying clean of other drugs. Some patients who have been in treatment for years only report to the clinic once a month, according to Prasad.
“Ideally, as they go through different phases, they earn more and more take-homes,” he said. “If they slip up, or they use at some point, and their urine analysis confirms that, they lose a take-home. It’s a trust system, it’s an incentive system. But it’s really a system to structure them through their recovery and help them get to a point of autonomy.”
That’s the main goal of CCG, according to Ostrovsky.
Although the clinic provides and encourages patients to utilize their mental health counseling, support groups and other resources, CCG tries to help patients with their individual needs, Ostrovsky said.
Most patients qualify for Medicaid to pay for the treatment, and Maryland’s laws incentivize the center to bill Medicaid for more counseling services than tests and medical procedures.
“But our goal is to meet clients where they are, whatever they’re ready for based on our clinicians’ assessments, that’s what we’re going to provide them with,” Ostrovsky said.