We are excited to share some recent attention our clinic has received!
The Obama Administration last week announced a change in the rules around a treatment for opioid addiction and instantly gave a boost to a small medical clinic in Tigard.
Recovery Works Northwest, which was founded in May 2015, will soon be able to nearly triple its patient load.
That’s because the federal government raised each doctor’s cap on the number of opioid-addicted patients they can treat with buprenorphine to 275 each from the current 100. The move will expand access to a medication-assisted therapy for which demand has skyrocketed in lockstep with the opioid epidemic in Oregon and across the country.
“We were anxiously awaiting this announcement,” said Dr. Bryan Schwartz, an addictions specialist and co-owner of Recovery Works, which was founded by his father, Dr. Benjamin Schwartz. “We’ve been inundated. We did 50 new consults last month. This provides some breathing room.”
The Schwartzes plan to add a second location later this year.
“In this market, there’s such an imbalance between supply and treatment, I don’t see any end in sight,” Benjamin Schwartz said.
An integrated approach
Before founding Recover Works, Benjamin Schwartz was an emergency room doctor at Willamette Falls Hospital in Oregon City. In the 1980s, he opened two urgent care clinics, Doctor’s Family Clinic and Immediate Care, which he sold to GoHealth Urgent Care last year. He used to treat addicts with buprenorphine at the urgent care clinics.
Bryan Schwartz, meanwhile, went to medical school in upstate New York, then did a residency in internal medicine on Long Island and worked as a hospitalist for two years. But behavioral medicine was always an interest, especially after he did an internship at UCLA in gambling studies. Bryan filled in at the urgent care clinic early last year, while his dad was on vacation, and discovered his true calling — treating addiction.
Unlike many smaller clinics that require all-cash pay, Recovery Works accepts all kinds of insurance, including Medicaid through FamilyCare Health. Besides the two Schwartzes, the clinic has two other part-time doctors and plans to open a clinic in the Gateway area of Northeast Portland this fall. The idea is to grow organically to other locations as the demand arises, Bryan Schwartz said.
While Recovery Works also treats other kinds of addictions — alcohol, tobacco and non-opioid drugs — most of its patients are there because of either prescription painkillers or heroin.
The clinic, however, does more than simply dispense buprenorphine, which also goes by the brand name Suboxone. Recovery Works offers an integrated program of medication-assisted therapy combined with counseling.
Bryan Schwartz noted that many clinics send patients to counseling but don’t necessarily follow up. But Program Manager Jen Robbinssaid Recovery Works’ model ensures that patients follow through on that piece of their treatment. Doctors and counselors regularly consult on cases.
“It’s really a team approach,” Robbins said. “We’re all making decisions together about patients.”
A ‘miracle drug’
The statistics in Oregon are grim. Between 2000 and 2013, 2,226 Oregonians died from prescription opioid overdose. Yet the prescriptions keep coming. In 2015, nearly 25 percent of Oregonians received a prescription for opioid medications. And the problem ripples further, as the pills often end up in other hands. In a national survey, the state ranked second in recreational use of pain relievers.
At this point, about 100 doctors are licensed to dispense Suboxone in the Tri-County area, according to the Substance Abuse and Mental Health Services Administration.
Suboxone, itself an opioid, helps patients control withdrawal symptoms and cravings for prescription painkillers and heroin alike but doesn’t get them high.
Many patients like the drug better than methadone, which requires a daily visit to a clinic, because Suboxone tablets can be dispensed in a 30-day supply, taken at home. Some patients can taper off of it eventually.
“It sometimes seems like a miracle drug,” Bryan Schwartz said. “It’s definitely the most satisfying thing I’ve done as a doctor. You take someone at the lowest point in their life and watch the transformation and see them become the version of themselves they’re proud to be.”
In addition to strict training requirements to dispense the drug, the government had instituted patient caps to thwart the black-market trade in Suboxone. Congress is considering legislation to raise the cap even further than the Obama administration, to 500, and allowing nurse practitioners and physician assistants to dispense as well.
Benjamin Schwartz said the increase to 275 will enable the clinic to get ahead of the problem and train more doctors.
“We’re on the front lines of this; we take care of people every day,” he said. “I think there will be a tsunami. We’re just trying to increase capacity to meet demand. If we can get 2,000 or 3,000 patients — my goal — we’d be scratching the surface.”
Dr. Marvin Seppala, chief Medical Officer of the Hazelden Betty Ford Foundation, agreed.
“We aren’t able to serve enough people across the country, with the opioid epidemic going on, and this change will be helpful in that regard,” Seppala said. “It’s a very positive move.”