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Trenton Healthcare Clinic

Medication Assisted Treatment

Trenton Healthcare Clinic

When someone who’s addicted to opioids stops taking them, the withdrawal symptoms can push them right back into using. However, Medication-Assisted Treatment (MAT) helps reduce the uncomfortable withdrawal symptoms, giving you or your loved one the ability to focus on recovery. MAT combines FDA-approved medications with behavioral and cognitive therapies bringing any underlying issues to light, as these may be contributing to the addiction. This two-fold approach of medication and therapy allows for a holistic approach and a greater chance at reaching recovery.

One of the biggest stigmas surrounding MAT is that it’s replacing one addictive drug for another. However, this just isn’t true, along with many other myths that have developed. Rather, when the medication is taken according to the doctor’s instructions, it’s just like taking medication for any other disease – and could mean the difference between someone reaching recovery and someone who relapses.

Trenton Healthcare Clinic offers a full range of comprehensive outpatient treatment programs and services, including:

METHADONE MAINTENANCE

INDIVIDUAL COUNSELING

GROUPING COUNSELING

CASE MANAGEMENT/SERVICES COORDINATED

INTENSIVE OUTPATIENT TREATMENT

PHYSICAL EXAMINATION

HIV ASSESSMENT

SHORT/LONG TERM DETOXIFICATIONS (90 to 180 days)

METHADONE MAINTENANCE

Depending on the patient, methadone maintenance may be the best course of treatment. Learn more about how methadone treatment works and if it’s the right choice for you.

SUBOXONE

Suboxone is the first opioid medication approved under DATA 2000 for the treatment of opioid dependence in an office-based setting. Suboxone can also be dispensed for take-home use, just as any other medicine for other medical conditions. The primary active ingredient in Suboxone is buprenorphine. Because buprenorphine is a partial opioid agonist, its opioid effects are limited compared to those produced by full opioid agonists, such as Oxycodone or heroin. Suboxone also contains naloxone, an opioid antagonist. The naloxone is there to discourage people from dissolving the tablet and injecting it. When Suboxone is placed under the tongue, as directed, very little naloxone reaches the bloodstream, so what the patient feels are the effects of the buprenorphine. However, if naloxone is injected, it can cause that person to quickly go into withdrawal.
Suboxone at the appropriate dose may be used to:
- Suppress symptoms of opioid withdrawal
- Decrease cravings for opioids
- Reduce illicit opioid use
- Block the effects of other opioids
- Help patients stay in treatment

SCREENING

An interview (either face-to-face or on the phone) will be conducted to complete the pre-screening form to decide appropriateness of potential admission.
If the person has the potential for admission, he/she is given an appointment to complete the initial assessment/intake process.
The assessment will occur face-to-face and include:
- An assessment tool that will assist in diagnosis and placement criteria
- A bio-psycho-social assessment
- Other information required by regulation and/or funding source (i.e., insurance)
Intake assessments are performed on a walk-in and appointment basis.
If an individual is found ineligible for services, the individual and the referring facility will be notified and offered alternative referrals for admission.
If the individual is eligible for services, he/she will proceed through the intake process, including
- Intake physical/assessment with the doctor
- Nursing assessment
- Lab-work
- Clinical intake process

ASSESSMENT

Please note: Information collected is used in the development of individual treatment plan.

The facility will complete an eligibility screening, which includes:
- A drug screen
- A comprehensive bio-psycho-social assessment
- Payment source to enroll in services
The initial assessment will be completed within 48 hours and psychosocial evaluation process will be initiated within 7 days of admission.
The bio-psycho-social will elicit:
- Medical status
- Vocational/employment and support
- Alcohol, tobacco and other drug use
- Legal status
- Family/social status
- Psychiatric status
- Co-occurring disorders history
- Behavioral risk factors for HIV and hepatitis
All client assessments will result in:
- A DSM diagnosis for alcohol, tobacco, and other substance uses
- An identified co-occurring disorder(s)
- Documentation of level of care determination
If the bio-psycho-social assessment indicates the client should be referred to another treatment program or level of care, the program will coordinate the client’s referral to another program and document the referral in a progress note.
If transfer to another program or level of care is indicated, interim services at current level of care will be provided until the transfer is actualized or the individual chooses alternate care.
A bio-psycho-social assessment will include:
- - Presenting issues from the client’s perspective and documented in their words
  - Medical, alcohol, tobacco, drug, and intervention history
  - History of psychological and/or psychiatric treatment (including previous admissions to psychiatric facilities)
  - History of suicidal/homicidal ideation and attempts
  - History of psychiatric treatment and/or psychotropic medications
  - Information of treatment by a psychiatrist or other licensed mental health clinician for clients diagnosed with co-occurring mental health disorders
  - Family and relationships, including relationships showing co-dependency and the client’s current living situation
  - Social assessment, including any legal proceedings involving the client.
  - Recreational assessment, including the client’s interests and physical abilities and limitations
  - Vocational and educational assessment of the client’s current work or vocational skills, employment status, and potential for improving those skills or developing new ones
  - Educational status and skills
  - Aptitudes, interests, and motivation
  - Physical abilities and any handicaps or disabilities
  - Relationships with co-workers and supervisors
  - Prior and current work or school related problems, including but not limited to those related to substance abuse
  - Urgent needs, including but not limited to:
    - Suicide risk
    - Personal safety
    - Risk to others
  - Personal strengths, needs, abilities/interests, and preferences
  - Previous behavioral health services, including diagnostic and treatment histories
  - Mental status
  - Medication profile
    - Medication history and current use
    - Effectiveness of current or previously used medications
    - Medication allergies or adverse reactions
  - Health history and current health needs
  - Co-occurring disorders, diagnosis and medical conditions
  - Current level of functioning
  - Pertinent current and historical life situation information
    - Age
    - Gender, sexual orientation, and gender expression
    - Culture and spiritual beliefs
    - Education
    - Employment
    - Legal involvement
    - Family history
    - Relationships and support network
    - History of experienced and/or witnessed trauma involving abuse, neglect, violence and/or sexual assault
Risk taking behaviors
Literacy level
Need for assertive devices
Advance directives
Psychological and social adjustment to disabilities and/or disorders
Resultant diagnosis, if identified

COMMUNITY EDUCATION

Includes the presentation of community education programs for community groups, organizations, businesses, and other organizations. These presentations are intended to increase public awareness of the nature of opioid addiction and the services available to treat this disease.

INDIVIDUAL COUNSELING

One-on-one therapy with patient and counselor.

GROUPING COUNSELING

Group counseling attempts to provide individuals a safe and comfortable place where they can work out problems and emotional issues. Patients gain insight into their own thoughts and behavior, and offer suggestions and support to others. In addition, patients who have a difficult time with interpersonal relationships can benefit from the social interactions that are a basic part of the group counseling experience.

Groups:

Provide positive peer support and pressure to abstain from substances of abuse.
Reduce the sense of isolation that most people who have substance abuse disorders experience.
Enable people who abuse substances to witness the recovery of others.
Help members learn to cope with their substance abuse and other problems by allowing them to see how others deal with similar problems.
Offer family-like experiences. Groups can provide the support and nurturance that may have been lacking in group members’ families of origin.
Encourage, coach, support, and reinforce as members undertake difficult or anxiety-provoking tasks.
Offer members the opportunity to learn or relearn the social skills they need to cope with everyday life instead or resorting to substance use. Group members can learn by observing others, being coached by others, and practicing skills in a safe and supportive environment.
Allow a single treatment professional to help a number of patients at the same time.
Can add needed structure and discipline to the lives of people with substance abuse disorders, who often enter treatment with their lives in chaos. Groups instill hope, a sense that “if he can make it, so can I”. Process groups can expand this hope to dealing with the full range of what people encounter, overcome or cope with in their lives.

CASE MANAGEMENT/SERVICES COORDINATED

Provide goal-oriented and individualized supports focusing on improved self-sufficiency for the patients through:
- Assessment
- Planning
- Linkages
- Advocacy
- Coordination
- Monitoring activities
Successful service coordinator results in community opportunities and increase independence for the individual/patient

INTENSIVE OUTPATIENT TREATMENT

Clinically-intensive treatment services 3 days a week for a total of 9 hours, including patients and their families receiving:
- Education and information regarding symptoms, effects, and treatment of mental illness, medications, substance abuse, co-dependency, and its effect on substance abuse treatment the implementation of self-care rehabilitation (such as Al-Anon, Nar-Anon, Alateen), and community agencies/resources available during treatment services.
Services provide individual and group substance abuse counseling, education on the health consequences of substance abuse and dependence, and relapse prevention.
Specialized services such as life skills, job placement, resume writing, vocational topics, and anger management.
Psychiatric services and medication monitoring provided for patients who have been diagnosed with co-occurring disorders or need psychiatric intervention and assessment.

PHYSICAL EXAMINATION

Each patient is seen by the Medical Director or other licensed practitioner before admission to assess the individual using ASAM criteria, make a proper DSM IV diagnosis, perform a physical and history examination, and develop appropriate medical orders for induction care.

HIV ASSESSMENT

A licensed nurse will compile a nursing history, which includes assessing risk factors for STDs, HIV, and HVC

SHORT/LONG TERM DETOXIFICATIONS (90 to 180 days)

Detoxification is hereby being defined as the process of assisting an individuals’ gradual metabolic clearance of a substance by means of pharmacological replacement with applicable and adjunctive treatment. This process will be conducted in such a manner as to minimize physical and psychological risk and discomfort to the patient and to thereby ultimately eliminate their dependence on those unhealthy and/or undesired substances while attempting to lessen the psychophysical discomfort in this process.
This will be accomplished through the medically-supervised cessation of all opioid (or other substances) intake by the patient and replaced by an alternatively prescribed opioid medication. During opioid detox, Methadone, a long-acting opioid medication will be administered in place of the opioid substance(s) currently being taken. This mediciation will be tapered/diminished over the clinically appropriate time frame. Detox will be available as a specialized program, independent of the medically-supervised tapering (withdrawal) that accompanies a patient’s separation from an opiate maintenance program, whether it’s voluntary or administrative in nature.

Programs

Medication Dispensing:

Monday through Friday
5:30 a.m. to 11:00 a.m.

Saturday
6:00 a.m. to 11:00 a.m.

Sunday
Closed

Counseling:

Monday through Friday
5:30 a.m. to 2:00 p.m.

Saturday
6:00 a.m. to 11:00 a.m.

Sunday
Closed

RCA Supports MAT

On Thursday, February 28, Trenton Healthcare Clinical celebrated our Medication-Assisted Treatment site in Trenton, NJ. Check out these videos from the event, which include speeches from Medical Director Dr. Michael DeShields, Program Physician Dr. Nigahus Karabulut, and RCA’s CEO Brian O’Neill.

Reviews

As a former Counselor, I was given an opportunity to serve our community of consumers in opioid addiction. Most of our progress was earned through insightful, helpful and compassionate collaboration between clients and staff. In this environment I was afforded the platform to both receive and offer the best therapeutic interventions to our clients.The Executive Director and Clinical Director are extremely proficient and work in tandem which keeps the agency vibrant and promotes Trenton Healthcare LLC to be a far better alternative to New Horizons. It's best that potential clients take a vested interest in their recovery wherever they choose to receive help. This is key to victory in recovery.To all prospective clients, please keep in mind that addiction is a "family disease" meaning one shouldn't go it alone. When entering into a MAT (Medications Assisted Treatment) clinic, have a family member or a trusted sober friend available for consultation / advice. Potential clients are vulnerable as they are suffering the devastating effects of SUD (Substance Use Disorder aka Addiction).Clinics are a services provider and follow a business model. Most agencies are "trending" towards IOP (Intensive Outpatient) Level of Care (10 hours per week).What if I have a job, family or other obligations that won't allow me that sort of time to devote to my recovery? Be sure to be honest with yourself. Maybe IOP would be a good starting point (duration: approximately 90 days). Or a lesser level of care (OP) would suffice allowing a client to recover, hold down a job and still have significant time with family. You know you're in the right clinic when staff are "client centric." It was my experience working at Trenton Healthcare LLC to be surrounded by counselors doing their best to ensure clients were advocated for by counselors' determined efforts to qualify clients for NJSAMS (New Jersey Substance Abuse Monitoring System) Medicaid benefits allowing clients to receive insurance (when applicable) to cover their pharmacotherapy. Much to the Clinical Director's credit, she over sees this process while training staff to ever improve the induction process. The benefit of this reduces the time clients first enter the door, speaks with a counselor, are examined by the doctors and receive medications to alleviate or reduce opioid withdrawal sickness.Your greatest resource in clinics are the doctors. After that be sure to put your counselor to work. Your success is up to you. Own your recovery, be vested and get your life back! Remember, "There's no one too stupid to recover, only too smart." "Having an attitude of gratitude determines your altitude!" Thank you.Be well,Arthur D Jones, MA

Arthur Jones

13:38 03 Feb 19

This place has helped me tremendously. I have been receiving treatment here for about six months. The staff is always polite to me. They have been very reasonable with their expectations and it's given me the space I have needed to gain stability.The first month it was a little frustrating because I continually had holds on my medication and my counselor would arrive 45 minutes after me. After settling in and getting a set appointment time to see him once a week it's been smooth sailing. The doctor is usually available to see the day I inquire or the very next.They are new so they are still ironing out the creases... But they are quick to make things right if I hold up my end.