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It has finally arrived!  As of October 2017, Arizona has the first 24/7 medication-assisted treatment (MAT) clinic in the United States.  With many methadone providers operating only 5 mornings per week, this new “always open” model could make great strides in providing accessibility to treatment for those who need it. This model is the first of its kind—a true proof of concept—to see how sustainable it is to provide 24/7 services to the Northern Phoenix region.  That is one of the hardest hit areas in the state for overdose fatalities.  The 24/7 drug rehab clinic provides methadone, buprenorphine and naltrexone and supportive treatment services whenever patients are in need. Community Medical Service, known as CMS, believes that this new 24-hour availability model in a hard hit part of the region will be instrumental in reaching those who need help but otherwise wouldn’t seek help. On one end of the client spectrum are the folks who have to balance treatment with responsibilities like jobs or school, and having expanded hours will certainly help them.  On the other end are those coming from emergency room visits or being released from incarceration when other addiction treatment providers are closed. The leadership at CMS had to fight against Arizona’s policymakers and their unyielding regulations on drug rehab programs.  CMS then has to work to change the community’s sentiments toward people affected by addiction.  There was a virtual torrent of complaints and opposition from residents, politicians, and business owners in North Phoenix when the clinic first made known its intentions to go 24/7. Now that it has been open for over a year, I imagine that the leadership team at CMS has learned a lot.  The regulations haven’t eased much and community sentiment doesn’t seem to have lightened up either.  So what did CMS learn that we can replicate with other treatment providers?  How important is it to offer services 24/7?  Drug rehab clinics in Wisconsin and Tucson have also turned to the 24/7 model, so it must be working, right? CMS had been exploring the possibility of expanding its operating hours for a long time.  There are many folks who work long hours and simply can’t show up to treatment for one, two, or three hours between 7am and 6pm.  All-hours-access also means that patients can walk in and begin whenever they are ready—no more calling at 2am and waiting until 9am to start treatment. Community Medical Services opened in 1983 and currently provides rehabilitation services to nearly 11,000 patients via 32 opioid treatment programs (OTP) across nine states.  As the largest OTP provider licensed to dispense methadone in Arizona, CMS provides the vast majority of its patients with the full opioid agonist.  A small fraction has been cycled off of methadone and onto Suboxone (buprenorphine and naloxone) or Vivitrol (naltrexone) instead after requesting it. Other takeaways that CMA recommends to those looking to learn from their innovations are as follows:

  • Addiction is a chronic disease and should be treated as such.
  • Compassion goes a long way.
  • Common sense solutions are often the best solutions.
  • There are effective ways to treat addiction—it doesn’t have to be a death sentence.
  • Punitive programs almost never work.

Click here to read the full interview from Zach Rhoads with the leadership at CMS.