Community Case Studies
Learn more about how we partner with community organizations.
lower rates of recidivism
Benton County Jail
Jails are a revolving door for individuals with opioid use disorder; an estimated 50% will end up incarcerated at least once in a year. Without appropriate treatment in jail, they will suffer severe withdrawal symptoms and, upon release, may immediately resume using drugs and end up back in jail. Or, they may overdose, unaware that their tolerance to substances subsided while they were incarcerated. Most jails are not equipped to stop this cycle.
Approach & Outcomes
Through a grant from the Health Care Authority of Washington, Ideal Option has partnered with Washington’s Benton County Jail, assigning Ideal Option medical staff to screen inmates for opioid use disorder and to initiate buprenorphine treatment. Patients continue to receive treatment throughout their time in jail and, upon release, are offered follow-up treatment at a local Ideal Option clinic, as well as counseling and other psycho-social support. “We’re able to catch these individuals at an opportune time, when they don’t have drugs in their system,” says social worker Skyler Glatt, Ideal Option’s director of special projects. “They can think more clearly, and their motivation for change is typically a lot higher. It’s a good time to intervene and say, ‘Hey, if you could get a fresh start on life, would you?’” Ideal Option continually follows up with patients once they are released. Says Glatt: “We‘ll ask, “How was the clinic visit? How else can we help you?’ If they don’t show up for their appointments, they’ll get a call once a week. We’ll say, ‘Is there anything we can do? Is sobriety something you’re still interested in?’ ”
In the first few months, the program has succeeded beyond expectations. Of the 500 patients inducted into the program, more than 150 have returned for follow-up treatment. “Compared to traditional counseling, that’s astronomical,” says Glatt. Preliminary data suggests recidivism is low. “These folks have been in and out of jail their whole lives because of their addiction, but they are finally getting treatment.” In addition, medication-assisted treatment (MAT) has gained buy-in among the jail’s nurses and corrections officers. “At first they would say, ‘Why are we giving drugs to drug addicts?’" recalls Glatt. “MAT is not widely known and still has some stigma.” But nurses quickly realized that treatment eliminates the withdrawal symptoms that required intensive treatment on their part, and corrections officers have noted fewer fights among inmates because they are no longer suffering withdrawal symptoms.
Community Outreach and Enforcement Team
Homeless individuals with substance use disorder face many barriers to treatment such as long waits for appointments and insurance authorization, and lack of transportation. These barriers add additional burdens to individuals already struggling medical, social, and psychological ills.
Approach & Outcomes
As a part of the Safe Streets initiative in Everett, Washington, Ideal Option partners with local law enforcement and social workers to offer homeless citizens with substance use disorders access to medication-assisted treatment. The Everett Police Community Outreach and Enforcement Team (COET), consisting of a dedicated police officer and embedded masters-level social worker, routinely visit homeless camps and ask individuals addicted to opioids if they would like to receive addiction treatment, as well as mental health, housing and other services.
Individuals who are willing to get treatment are provided transportation directly from the street either to a diversion center or to the Ideal Option clinic, in some cases beginning medication-assisted treatment within hours. This process circumvents the numerous barriers to successful treatment. “Many of these folks have burned all their bridges with their family and don’t have anywhere else to go,” says Traci Enriquez, Ideal Option’s referral coordinator. “They’re very grateful for this opportunity. They’ll say, ‘If I keep going the way I’m going, I’ll be dead.’”
With coordinated support from multiple services, homeless individuals are able to settle gradually into a stable treatment schedule and begin to get their lives back in order.
The unique partnership with COET has already provided over 200 homeless individuals with access to evidence-based addiction treatment, a success recognized by the city of Everett. “It’s amazing to see patients who have gotten off the streets and are getting back on track,” says Enriquez. “They’ll say, ‘My mom’s talking to me now.’ It’s a huge step in the right direction.”
By connecting homeless patients directly with treatment in this unique public/private pilot program, Ideal Option is able to close gaps in the treatment system and help a community facing complex issues of homelessness, mental illness, crime, and addiction.
Decreased ED Utilization
Hospital Emergency Departments
Emergency departments are inundated with patients who have overdosed on opioids, are in the throes of withdrawal, or have been injured in drug-related accidents. By receiving buprenorphine immediately along with a warm referral to ongoing medication-assisted treatment, patients can avoid the consequences that result from delays between referral and treatment.
Approach & Outcomes
Ideal Option partners with numerous emergency departments (ED) to identify appropriate candidates for buprenorphine treatment and to facilitate warm handoffs between the ED and their outpatient medication-assisted treatment clinics.
Via phone consultation and written protocols, Ideal Option practitioners help ED providers initiate treatment, eliminating administrative, financial, and time barriers to care. Ideal Option also performs on-site training and education for ED practitioners and staff.
“EDs will call me the middle of the night and say they have a patient in bad withdrawal and want to get them started on MAT,” says Traci Enriquez, referral coordinator at Ideal Option. “The patient will get the first dose in ER, and I’ll schedule them to be seen by a provider in a local outpatient clinic the next morning. We can even help arrange rides for patients or bus passes paid for by Medicaid. It works a lot better than saying to the patient, ‘Here’s a number you should call for treatment.’”
Ideal Option has helped numerous emergency departments treat patients for substance use disorder and promptly transfer them for ongoing care to a local treatment center. Getting patients who are ready to start treatment scheduled for their first appointment within 24 hours is critical to ensure patients show up, begin, and remain in treatment.
These critical referrals did not exist a few years ago and more work is to be done to expand this partnership model into other communities.
In one recent study, ED utlization was shown to be 43% lower among patients in the 30 day period after treatment with Ideal Option. Other data conclude that evidence-based medication assisted treatment for patients with opioid use disorder is associated with decreased healthcare costs in this population.