Medication-Assisted Therapy for Opioid Dependence: the Betty Ford Model
"COR-12 is a treatment path that includes group therapy and lectures that focus on opioid addiction, as well as 2 extended medication assistance options,” said Bruce Kaplan, MD.
The Hazelden Betty Ford Foundation, an organization that uses outreach, advocacy and treatment centers to provide hope and recovery to addicts and their families, has developed a Comprehensive Opioid Response with the Twelve Steps (COR-12™), a medication-assisted treatment program for individuals with a dependency to opioids.1
“COR-12 is a treatment path that includes group therapy and lectures that focus on opioid addiction, as well as 2 extended medication assistance options,” Bruce Kaplan, MD, Director of the Pain Management Program at the Betty Ford Center in Rancho Mirage, California, told Clinical Pain Advisor.
The 2 medication assistance options include either the use of buprenorphine/naloxone (Suboxone®), or extended release naltrexone (Vivitrol®), which is provided under closely supervised care.
“In addition, the third arm of COR-12 provides buprenorphine to the subset of patients who, once detoxified, demonstrate an inability to tolerate post-acute withdrawal syndrome symptoms within the time allocated for Hazelden Betty Ford recovery and treatment. These patients are subsequently discharged to a COR-12 Hazelden Betty Ford physician and group, as the patient works towards abstinence,” Dr Kaplan said.
Dr Kaplan noted that patients can also choose to participate in COR-12 without assistance from medication.
Drug addiction has surpassed car accidents as the number 1 cause of accidental deaths in the United States, with 42 032 overdose deaths in 2014 compared with 33 736 deaths from car accidents in 2014.
According to the CDC, deaths due to prescription pain relievers have more than quadrupled, rising from 4,040 in 1999 to 18 893 in 2014.2
In addition to the medication options and the 12 steps to recovery that addresses addiction through acceptance, spirituality and forgiveness-seeking, the COR-12 program includes a personal opioid addiction treatment plan.3
This plan is developed by a clinical care team and is designed based on the nature of abused substance(s) and the patient's physical and mental health, gender and familial relationships. Treatment plans include individual and group therapy, educational lectures, and specialfocus groups.
“In my opinion, medication-assisted treatment for addiction is no different than medication-assisted treatment for any other disease,” said Joseph Lee, MD, Medical Director of the Hazelden Betty Ford Foundation Youth Continuum, in footage appearing on the Hazelden Betty Ford website.1
According to Dr Kaplan, doctors have used non-opioid medications to facilitate detoxification and post-acute withdrawal syndrome. “Antidepressants, anti-anxiety, antiepileptic, and muscle relaxant medications are representative of the ancillary medications used to promote a ‘smooth landing' during detoxification and subsequent post-acute withdrawal syndrome symptomatology,” Dr Kaplan told Clinical Pain Advisor.
The Hazelden Betty Ford Foundation also advocates for improvements in access to addiction treatment, works to ensure that the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) is properly enforced, and aims to reduce the stigma associated with addiction.4
“We must move past stigma and let evidence-based science and compassion guide our response to this crisis,” declared Marvin D. Seppala, MD, Chief Medical Officer.5
According to Dr Kaplan, the Hazelden Betty Ford Foundation Butler Center for Research is following several medication-assisted patients in the COR-12 program, and hopes to release its findings in the coming year.