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Yolanda Fleming

To meet a growing demand for services related to opioid and substance abuse, Trinitas Regional Medical Center now offers several levels of care in the Substance Abuse program. The new, expanded hours are now Monday-Thursday, 8AM-9PM, and Friday from 8AM-4PM in the Plaza Building (across the street from the main New Point building).

"There has been a tremendous increase in need for substance abuse treatment services with the opioid epidemic in the forefront of discussions," says Krystyna Vaccarelli, LCSW, LCADC, and Director of Substance Abuse Services at Trinitas.

"Long gone are the days of addiction hiding in the shadows of treatment, rarely spoken about. Now, one is hard pressed to not be able to talk about someone they know, or know of, that has dealt with some aspect of addiction, even more specifically, opioids. In order to meet the needs of this recognized epidemic, we have expended our hours and added additional groups and clinicians. We will continue to grow our services as we fight back for our community and in it, our brothers and sisters."

According to Vaccarelli, all patients receive an intake, including an evaluation with a psychiatrist. Patients are evaluated for any additional mental illness that requires treatment, and, if they are appropriate for MAT (Medicated Assisted Treatment).

"We have both Vivitrol and Suboxone available to aid in the treatment process," she says. "Studies have found that Suboxone has a positive effect on the lives of people recovering from addiction. When someone takes Suboxone, buprenorphine binds to receptors in the brain and activates them only slightly, providing relief from withdrawal symptoms, while the naloxone blocks the opioid's effect, keeping the body from experiencing any kind of high."

A study published recently in the Journal of Community Hospital Internal Medicine Perspectives found that Suboxone treatment correlated to up to 45% fewer emergency room visits among test subjects.

The levels of care include Partial Hospital (PH), which offers patients treatment five days a week for five hours a day. "This is the most intensive outpatient level," says Vaccarelli. "Patients get concentrated treatment addressing areas of relapse prevention, denial, triggers along with topics such as grief and loss, problem solving/coping skills and family/relationships. Patients get weekly individual therapy. This program runs continuously and a patient can be at the PH level of care anywhere from two weeks to several months, depending on clinical need.

Intensive Outpatient (IOP) offers care between three and four days for three hours a day.

"The hours of treatment may be less, however, the intensity remains," she says. "Topics continue to get addressed, but with an expectation of a clearer understanding of the topics. Typically, patients are farther along in their recovery at this point. This level of care typically lasts about three months. Individual sessions are weekly. A relapse will prompt the patient back up to the PH level of care."

Outpatient (OP) treatment is held once a week for two groups, and patients meet for individual sessions once a month.

"These patients are typically the most solid in their recovery," according to Vaccarelli. "Patients continue to work on topics of dealing with triggers and People, Places and Things to continuously aid in their recovery."

An Outpatient Medication Group meets once a week for patients requiring continued medication monitoring.

In the Women’s Addiction Services Program, the levels of care are the same; however, they specifically deal with women's issues and topics. Within this program, there is a Trauma track and Project Sustain, a partnership with the YMCA that provides housing for up to six months on a stipend to four substance-addicted women who are either pregnant or have children ages 12 years old and under, as long as they remain in treatment.

"Many of our clients would not have custody of their children if not for this program," Vaccarelli says.

There is a Child Care Room with a staffer who looks after the children while their moms receive substance abuse treatment for up to four hours a day. Transportation is provided to and from the program.

In the Emergency Department at Trinitas, a grant from Horizon Blue Cross/Blue Shield has funded 1.5 licensed clinicians (one LCADC, the other LCSW, LCADC) to be stationed in the Medical Emergency Department to identify patients as under the influence. The clinician then meets with the identified patient and completes an SBIRT (Screening Brief Intervention and Referral for Treatment) together with Denial management or brief bedside supportive therapy. These same clinicians use screening tools such as Audit, Cage and ASI to determine severity of addiction. The optimal outcome is a referral and linkage to a program/ treatment.

"They use motivational interviewing techniques to engage these patients, assess them and get their needs met through various connections and referrals," Vaccarelli adds. "This is an effort to get patients in the appropriate care and reduce their ED visits. This program is particularly successful."

There is also an Addiction Specialist on the inpatient units at the Williamson Street Campus of Trinitas. When a patient is identified as someone in need of addiction services through the audit score, the Addiction Specialist is called in to meet with the patient and make an assessment/recommendation for treatment once the patient is discharged.

"Often, the patient is discharged to the Substance Abuse Program where it becomes a departmental collaboration to engage the patient into treatment and to meet the patients' needs."


About Trinitas Regional Medical Center
Trinitas Regional Medical Center (TRMC), a major center for comprehensive health services for those who live and work in Central New Jersey, is a Catholic teaching medical center sponsored by the Sisters of Charity of Saint Elizabeth in partnership with Elizabethtown Healthcare Foundation. With 10 Centers of Excellence across the continuum of care, Trinitas has distinguished itself in cardiology, cancer care, behavioral health, renal care, nursing education, diabetes management, wound healing and sleep medicine.

Posted: February 21, 2018

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