UK HealthCast: How the SMART Clinic helps with addiction recovery

UK HealthCast is a podcast series featuring interviews with UK HealthCare experts on a variety of health-related topics, from how to recognize stroke symptoms to what patients need to know about clinical trials – and more.

For this edition, we spoke to Gray Manis, LCSW, and Dr. James Hawthorne, co-directors of the Supportive Mental Health and Addiction Recovery Treatment program (better known as the SMART Clinic Program).

What exactly is the SMART Clinic?
 

Manis: At the SMART Clinic, we provide innovative and comprehensive addiction treatment and trauma-informed psychiatric services to people that have substance use disorders who may also have co-occurring disorders. And we do this in an outpatient healthcare setting where they can also get their primary care needs met. We offer a variety of different services that include medication for opioid use disorders … We also offer psychiatric care for folks who have other mental health disorders in addition to their substance use disorders. We offer a SMART parenting track for postpartum women.

We do treatment for alcohol and other substance use disorders … with both group and individual therapy. We really emphasize the need to treat trauma because many of the folks who have substance use disorders have histories of trauma.

How does this benefit the community?

Hawthorne: Many people are aware that addiction is a big problem in Kentucky. Especially with the opioid epidemic, but also with addiction to other substances, this is something that has been very harmful to the communities that we work with. Unfortunately, many people know someone who has struggled with a substance use disorder, or even known someone who may have passed away from overdose or complications of addiction. Others may have struggled with addiction themselves. What we're trying to do here in the SMART clinic is offer comprehensive outpatient treatment for substance use disorders.

We're really trying to do our part to be one piece of the puzzle to address what is a big societal problem in Kentucky between opioid addiction, alcohol addiction, cocaine, methamphetamines, all of these things have been very disruptive and we are trying to do what we can to help address the needs of people struggling with addiction, in an outpatient treatment setting.

Can you describe the care team that treats patients at the SMART Clinic?
 

Hawthorne: Mental health care generally, and substance use disorder treatment in particular is best when it's multidisciplinary and includes a comprehensive care team. So, that's what we try and do here. When patients come to the clinic, there'll be a careful assessment of what they need and based on this we will connect them with a care team to address their needs.

The care team will typically include a physician or nurse practitioner, as well as a therapist who would work with the patient individually or in group, depending on the exact needs of the patient. Patients would also have a social worker who would be able to do case management if needed and a peer support specialist who would meet with them regularly to help guide them through what can be a pretty complicated process of recovery and a complicated system of care.

There really is a breadth of different providers and staff in the SMART clinic who are available to work with patients and ensure that all of their needs are addressed.

Can you explain the parenting program at the SMART Clinic?
 

Manis: It's really an outpatient substance use disorder treatment program for postpartum and parenting women. It's within the SMART Clinic, so these patients are getting the same services as everyone else, or have access to the same services as everyone else, including medication treatment for opioid use disorder, as well as psychiatric care, individual and group therapy.

But in addition to that, because they are postpartum women, they're getting parenting education and support. There's a focus on supporting them as they parent their children, and at the same time deal with their addiction and get into recovery.

Hawthorne: We've got a group of staff and providers who are really experienced in working with this population and helping guide them through what can be a confusing and overwhelming process. Often, there is involvement of the courts, child protective services or complicated situations surrounding custody that are tricky to navigate and very stressful for women as they try and work on their own recovery. The parenting track in the SMART clinic offers extra support for women who are facing these problems.

What should a patient should expect at their initial appointment?
 

Manis: From the moment that they make the phone call to our clinic for an intake, they will speak with someone who will get information from them and based on that information, they will determine who they need to see. When they do come in, they will meet with either a physician or a nurse practitioner, as well as a social worker who will then do a comprehensive assessment and determine what the next steps will be for them.

Hawthorne: You will meet with the core members of your care team during your first visit. They will take a detailed history, really get to know you and try and figure out how best we can help you.

There is emphasis on understanding your substance use problem, understanding any kind of mental health problems you might have, in addition to that, any kind of physical health needs you might have, any sort of social needs that need to be addressed. You really come out of that first appointment with, hopefully, a good understanding of what the treatment plan should be going forward to help you get back on track, and headed toward recovery.

How does a patient actually go about scheduling an appointment?
 

Hawthorne: The best thing for the patient to do would just be to call the clinic. The direct line for the SMART Clinic is 859-562-2356. When you make that phone call, be prepared to tell us a little bit over the phone about what sorts of problems you've been having with a substance use disorder and what sorts of treatment you think you might be looking for so that we can know which of our providers to have you see for your initial appointment.

Manis: We realize that reaching out for help and making that initial phone call can be pretty frightening for some people. They may have come to a point of desperation when they're willing to ask for help. We realize how hard that is and how scary that can be. We welcome folks who are desperate. We welcome folks who are hurting and have just been ravaged by addiction, and we are excited about helping people take their life back.

Listen to this episode of UK HealthCast: