Providing Comprehensive Options and Increased Access to Treat Opioid Use Disorder

The care team at the University of Minnesota Physicians Broadway Family Medicine Clinic is taking a uniquely comprehensive approach to battling the opioid epidemic and helping patients with opioid use disorder.

Currently, there are three FDA-approved treatments for opioid use disorder: methadone, buprenorphine, and naltrexone. Methadone treatment administered daily at a designated methadone clinic is the long-standing model. Although this approach has proven successful, the Broadway clinic has implemented an office-based program administering buprenorphine and naltrexone to provide patients with treatment options.

Office-Based Program Offers Comprehensive Treatment for Patients Across the Region

Although buprenorphine has been available since the 1970s it has recently gained traction as a treatment for opioid use disorder particularly as it has reached epidemic levels. Patient benefits of buprenorphine treatment include that office visits are generally twice a week for the first few weeks of treatment and then often decreased to monthly office visits as the patient stabilizes on their dose, offering more convenience to patients than daily visits to a methadone clinic for their medication. Naltrexone treatment includes a monthly injection, which is preferable for some patients.

While buprenorphine and naltrexone offer needed treatment alternatives, the ability to prescribe buprenorphine requires providers take eight hours of training, and that requirement has slowed the adoption of this option, even as the need has dramatically increased.

The clinical team at the Broadway Family Medicine Clinic lead by Kacey Justesen, MD, Tanner Nissly, DO, Bob Levy, MD, and Michelle Sherman, PhD, have embraced the buprenorphine option and created a robust, fully-integrated program to increase treatment access for patients with opioid use disorder from across the region.

In addition to offering an important treatment option, the true patient advantage of the program is the comprehensive approach and access to resources and support offer to all patients with opioid use disorder. As a primary care clinic, patients receive vital medical and mental health services that they may not have access to in a traditional methadone clinic. The providers, psychologists and care coordinators at Broadway Family Medicine Clinic collaborate to ensure each patient has the appropriate care and support to deal with physical, behavioral, social and environmental barriers to their recovery.

“Unfortunately, chronic use of opioids can take a significant toll on a patient’s physical and mental health, and other factors – home life, employment, access to support – need tending to, ” said Dr. Justesen. “Our capability to address those conditions and care holistically for the patient, helps keep them on track. Recovery is a journey with ups and downs, and it’s important to support the patient with comprehensive care.”

Increasing the Number of Qualified Providers to Increase Overall Access

Despite efforts to meet the demands presented by the current opioid crisis, access to effective treatment alternatives remains limited. The training requirement has resulted in fewer providers available to administer the buprenorphine and naltrexone treatment. The Broadway clinic residency program is also helping to fill this gap.

The Broadway clinic is home to a large family medicine residency program. There are 24 residents in the program and all are being trained to prescribe medication-assisted treatment (MAT). In addition, approximately 70% of graduating family medicine residents stay to practice in Minnesota which will increase access to these treatments across the state. Thus, the Broadway clinic is increasing the overall number of physicians qualified to administer these treatments and manage office-based programs, improving overall access to care.

“With eight to 10 residents graduating every year, that’s eight to 10 physicians beginning their practices that can take this knowledge and skill to the community,” said Dr. Justesen.
“My experience in the Broadway residency program has given me a passion to take this care model to the community,” said Alex Gits, MD, a 2019 graduating resident. “I am confident we can increase access to these treatment options and help the communities of Minnesota.”

In addition to the residents and other faculty members offering the office-based treatment program, the MAT care team is led by:

Kacey Justesen, MD, Program Director
Bob Levy, MD
Tanner Nissly, DO
Michelle Sherman, PhD, ABPP, Clinical Psychologist
Talisha Lormeus, LSW, Care Coordinator/Social Worker

To refer a patient call the Broadway Family Medicine Clinic at 612-302-8200.