Allegheny Health Network Takes New, More Holistic Approach To Addiction Treatment

Apr 16, 2019

Allegheny Health Network is implementing and expanding programs to treat substance use disorders. 

One change begins in the primary care office, where people see generalists for annual checkups and, over time, often develop a rapport with their doctors.

At these appointments, AHN primary care doctors will now screen patients for alcohol and opioid use and mental health issues. When someone screens positive they will be connected to a care coordinator.

“So, in the past, someone would identify an issue, but they didn’t have the tools or anywhere to send these patients,” said Dr. Bill Johnjulio, head of AHN primary care. “Now what they’re doing is giving the tools and environment to wrap the services around the patient.”

Johnjulio said smaller trials show this approach is more cost-effective and successful at getting patients into treatment. He attributed this success, in part, to the fact that primary care doctors are initiating these interventions.

“We find that relationship and that environment where they feel safe and [have received] care prior creates a much stronger bond, and a much stronger willingness from the patient to believe and trust in the [treatment] offerings,” he said.

If patients have opioid dependency issues, in addition to medicated assisted treatment, they might also be referred to AHN’s holistic pain management program, which the health care network is expanding.

A person can develop opioid dependency after receiving a prescription to manage pain from a injury or surgery, so their addiction might be entangled with chronic pain issues. AHN wants to replace powerful medications with more holistic treatments.

“These interventions include massage, acupuncture, behavioral health and physical therapy,” said pain medicine specialist Dr. Jack Kabazie.

Public health workers and harm reduction advocates warn that taking away someone’s prescription opioids is often the catalyst for that patient turning to illicit substances, such as heroin or fentanyl. But Kabazie said the program does not take a cold turkey approach.

“We slowly wean the patient as we institute other treatment modalities, that’s different than just taking someone’s opioids away,” said Kabazie. “When you take someone’s opioids away, and you take them away quickly, and you don’t replace them another treatment path, that’s when patients will turn to the street.”

Allegheny County Health Department Director Karen Hacker said she’s pleased by these AHN initiatives.

“From my perspective [the opioid crisis] is not all that different from the HIV [epidemic,]” said Hacker. “We have to address this issue from multiple angles.”

As the programs mature, Hacker said she will be watching closely to see if the county’s opioid overdose fatality rate continues to decline.

WESA receives funding from Allegheny Health Network.