Swinomish
Wellness
Program
Suboxone Component
Gil Traylor MD
Chad Walker, BS, CDP
Our Vision
 Reduce
Health risks in the community
 Minimize the impact of criminal behavior
 Keep families together
 Improve quality of life for community
members
Swinomish Wellness Program
 State
Certified Chemical Dependency
Program
 Services Offered:
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Intensive Outpatient
Outpatient Treatment
Individualized Programs
Youth Treatment
Assessments and Referral
Suboxone and Vivitrol (Naloxone)
Why is it needed?
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Increased number of patients seeking services for
opiate dependency.
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Prior to program 1 opiate dependent person in
outpatient treatment
Limited treatment options due to funding sources
and remoteness of the community for sources.
Funding process was taking too long
Abstinence based treatment ineffective, poor local
detox options.
Limited Medication Assisted Programs in area i.e.
Methadone or Suboxone-nearest 30 miles away
As we change from alcohol to opiates, we need to
treat opiate addiction with opiate treatment.
Treatment Overview
of Opioid Dependence
ABSTINENCE
MEDICATION
ASSISTED
ABSTINENCE
Methadone
Buprenorphine
HARM REDUCTION
Needle Exchange
DEATH
What is
Suboxone(Buprenorphine)?
 Narcotic
Medication
 Used for substitution of Heroin, Pain pills
and other opiates
 Binds to the mu-receptor
 Prescription from Suboxone Certified
Physician only
Why Suboxone?
 Suppress
opiate withdrawal symptoms
 Reduces cravings
 Success rate is much higher with
medication
 Lower abuse potential than Methadone
 Faster set up time, no added certification
for Wellness Program
Admission Process
1.
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6.
Chemical Dependency Assessment, dx of
opiate dependence 304.00
Refer to Medical Clinic for physical and
blood work (our requirements)
Schedule admit appt. for treatment
program.
Schedule Doctor appt. for physical.
Treatment team meets with physician.
Pt. attends induction appt. in full withdrawal
and is written a prescription
Phase I ~ 12 weeks
 Treatment
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Intensive outpatient
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Three groups a week
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Cultural Component-reintroduction to storytelling, nutrition, traditional
foods, beading, history, crafts, canoe journey.
Individual session per week
Suboxone Orientation
Weekly to bi-monthly doctor appointments
UA’s
Strip Counts
 Introduction of Mental Health
 Group Education
 Referral for Individual sessions
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(Based on patient needs assessment)
Evolving treatment ~ Empowering patients……..
Phase II ~ 16 weeks
 Treatment
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Relapse prevention
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Two group sessions per week
Individual session bi-monthly
Monthly doctor appointments
UA’s
Strip counts
 Mental
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Health
Group Education
Individual sessions as needed
Based on patient needs assessment
Phase III ~
 Maintenance
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Duration based on patient need
program
Recovery support group
Monthly individual counseling
Doctor visits as needed
UA’s
Strip Counts
Controls for Diversion
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Pharmacy
1-3x/week pickup at Pharmacy
Suboxone UA’s
Strip Counts
Strict diversion Contract
Healthy community Tip Line-dealing
SWP numbers since July 2012
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1st year admissions-40
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8 still in program
2nd year admissions-22
16 still in program
 7 returning patients from 1st year
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3 Program Graduates detoxed off of Suboxone
Currently have 24 active participants
13 have over one year of sobriety!!
QUESTIONS???
“Live life without
the need of
alcohol and
other drugs.”