New Connecticut program to address youth misuse of opioids

A new, federally funded program will use three types of evidence-based treatment to keep Connecticut adolescents with opioid use disorder from spiraling out of control.

Called the ASSERT Treatment Model, the first-of-its-kind program can serve 94 youths and their families simultaneously, Gov. Dannel P. Malloy said Wednesday. Adolescents and adults up to age 21 can be considered.

“It is tragic, but this crisis is hitting young people just as it is adults, and it is critical that we provide treatment as soon as it is discovered,” Malloy said.

Locally, nonprofit United Community and Family Services will administer the model. The first element of it is Multidimensional Family Therapy (MDFT), which is designed to help adolescents who have substance abuse issues.

Cyndi Palma, a licensed clinical social worker who oversees MDFT for UCFS, said clinicians will visit youth accepted to the program two to three times a week. They’ll also work with each client’s immediate support system, whether that’s a parent, grandparent, cousin, partner or even roommate.

“We tweaked (MDFT) for this population by changing the definition of family,” she said. “A lot of these older adolescents and young adults are out of the home.”

Clinicians will spend three to five hours a week with each case, divided between individual therapy with the adolescent, individual therapy with the support system and group therapy with both parties.

“What’s different is we’re bringing treatment to them, to their environment,” Palma said. “We’re helping them make changes in their environment that are going to support their recovery.”

Palma said UCFS long has used the evidence-based family therapy model but clinicians generally have worked with youth who smoke marijuana, drink alcohol or experiment with other drugs.

“Never have we worked with opiates before,” she said, “so this is new.”

The second evidence-based component of the program is access to medication-assisted treatment such as Suboxone or Vivitrol. Each works differently but in general the medications allow a person to function without intense withdrawals or cravings.

UCFS already offers both medications. It plans to connect young clients who are interested with a prescriber, who will determine whether they should go on treatment and will monitor them if so.

For those adolescents who want more than two or three visits per week, recovery coaches will be available. Also considered an evidence-based approach, the coaches can help clients find jobs and housing, attend meetings, apply for benefits such as HUSKY Health insurance and provide ongoing support for up to a year.

Palma expects many referrals to the program will come from probation officers and the state Department of Children and Families but she said pediatricians, psychiatrists, therapists and families themselves can refer an adolescent. The process involves filling out a “very simple” two-page form, she said.

"When it comes to adolescents, the opioid use falls under the radar," Palma said. "Parents don't see it because it's not something that's a full-blown problem yet."

In 2015, more Norwich students reported having used prescription drugs in the past 30 days than alcohol or marijuana, prompting the city to launch a campaign to tackle the issue.

And, in April this year, a 17-year-old New London High School student named Luis Roman died from the toxicity of fentanyl, according to the Chief Medical Examiner Dr. James Gill. Fentanyl is an opioid drug that’s 50 times stronger than heroin.

“We need to do more work on identifying these adolescents and getting them into treatment early before it spirals into a more serious addiction,” Palma said.

UCFS can take on 24 clients under the new program and is prepared to expand further, if necessary.

Participation will be based on the need in the community, said Michelle Melendez, manager of substance use services for UCFS.

DCF selected UCFS for the four-year, $352,000 grant, which came from the federal Substance Abuse and Mental Health Services Administration. Providers in Meriden/New Britain, Hartford/Manchester and Danbury/Torrington/Waterbury also received funding for the program.

Melendez said insurance covers the therapy component, though it may result in a copay for the medication. Medicaid covers the medication in full. But those who have no ability to pay won’t be stopped from accessing services, she said.

“We will cover them through the grant money,” Melendez said. “At UCFS, we believe in making sure clients get the services they need.”

To learn more about or refer someone to the ASSERT Treatment Model, contact Cyndi Palma at (860) 822-4292 or cpalma@ucfs.org.

l.boyle@theday.com

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