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Opioid treatment, group therapy program comes to New Albany

NEW ALBANY, Ind. (AP) – An opiate recovery organization that prescribes addiction treatment medication and requires weekly group therapy sessions plans to open in New Albany at the end of the month.

Groups, the brainchild of a Dartmouth College medical resident, bills itself as an evidence-based, higher standard approach to the opioid epidemic in rural communities.

The organization hopes to open its doors in New Albany on March 27.

“I think the primary focus of the program is to not just provide care, but to provide compassionate care and raise the bar with every patient and their action,” Elizabeth Zeinner, Midwest regional manager for Groups, said in a phone interview Wednesday.

Groups combines Suboxone, an opioid treatment medication, with group cognitive behavioral therapy, or CBT, over an 18-24 month period. Patients are allowed to attend group sessions longer than their program duration if they wish to maintain any relationships they foster.

Patients must come to weekly sessions to receive a seven-day prescription of Suboxone. Also required at their visits is a urine test to screen for drug use.

Patients with insurance are charged a flat $65 weekly fee, and those without insurance may be eligible for grants, Zeinner said.

“Our treatment’s very personal,” she said. “We don’t have a cookie-cutter treatment program, and we try to treat each patient individually.”

Groups is not required to receive certification from the Indiana Family and Social Services Administration to operate an opioid treatment program, because it won’t be administering methadone. Compliance through the state department means adhering to stringent rules.

The organization is instead credentialed as a physician’s office and certified through the Indiana Department of Mental Health and Addiction.

Because they aren’t subject to opioid treatment program certification, Groups is not affected by New Albany’s new zoning requirements for addiction facilities preliminarily passed by the city council.

New Albany Planning and Zoning Director Scott Wood is researching the effects of medical practices that focus on Suboxone prescriptions on communities. He may recommend new zoning requirements relating to these facilities for the plan commission and city council to codify into law.

“Right now, we don’t know whether there are any adverse effects from it,” Wood said, mentioning “nuisances” to the community such as parking or loitering.

He’s not sure whether any new requirements, if passed, would apply to Groups.

“We’re just trying to imagine those types of things and see if we can head them off,” he said.

Unlike opioid treatment programs, medication at Groups isn’t administered onsite. Patients are given prescriptions, which they must fill at only one pharmacy of their choice.

Suboxone is a combination of buprenorphine, which partially activates the brain’s opioid receptors, and naloxone, an opioid overdose withdrawal medication. Methadone, by comparison, fully activates opioid receptors.

“Methadone is much more easily abused,” said Zeinner, who is a former paramedic.

Suboxone has a ceiling effect, meaning its pain-relieving effects plateau at a certain moderate dosage. If more opioids are used in combination with Suboxone, the naloxone in the drug will cause people to experience withdrawals. The U.S. Substance Abuse and Mental Health Services Administration reports Suboxone has a lower potential for abuse and addiction while still diminishing the effects of withdrawal.

Groups recognizes Suboxone does have “street value,” meaning tablets or films placed on the tongue can be sold illegally.

To minimize resale, Groups will conduct random pill counts every week for three out of every 15 patients. Each individual Suboxone tablet or film is marked with its own barcode, which tells doctors where the prescription was filled and to whom. Zeinner said that means a patient must have the exact number of pills dependent on the day the pill check occurs – and the pills must belong to them.

“We try to be strict on these things, because the last thing we want to be is a hindrance to the community,” Zeinner said. “We want to help.”

Zeinner doesn’t expect Groups to cause a traffic burden in New Albany. No more than 15 people will be in the office at once, as they must come in for scheduled sessions at different times throughout the day, she said.

That differs from methadone clinics, which may see up to 1,200 of the same patients who return for their medication daily, Zeinner said.

Floyd County’s rate of drug-related deaths have hovered between 13 and 19 the past five years, according to the Floyd County Health Department.

Those numbers are low compared to surrounding communities, of which New Albany is the central location. Zeinner said there aren’t medically assisted treatment providers in Floyd County, which is another reason Groups decided to locate there.

“It is close to the hospital, and that being important because hospitals are great resources for our patients when we talk about wrap-around services,” she added.

Groups also has locations in Aurora, Bloomington, North Vernon and Greensburg. They’re also in the process of opening a Connersville location.

The company was founded about three and a half years ago. Zeinner said New Hampshire programs have graduated more than 40 patients.

“Our ultimate goal for our all patients is abstinence,” she said.

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