Much of the work you do as director of addiction medicine is expanding access to care. Tell me about your latest efforts in that mission? What are we doing at UI Health Care that’s unique to the state?
Something that we need to do on an ongoing basis is reduce stigma and recognize that addiction is a medical condition. We have a lot of really good treatments, but a lot of people don't have access to those treatments. If people don't feel safe asking for help or disclosing that they are struggling, they can't get treatment. I think we need more clinicians who are comfortable addressing these issues. Some of that requires education, and some of that's about having a well-staffed workforce.
We see many people with opioid use disorder, and we still mainly prescribe buprenorphine for them, and it works well. Every week I get to see people whose lives have been changed for the better because they have access to that treatment. So, we still have that foundation. And now, we're starting a methadone clinic as soon as we finalize clinic space. Methadone is just another really effective medication that can work for some people when buprenorphine doesn't work.
Also, we have added recovery coaches to our care team. These are people who are in recovery themselves, and they're hired because they have lived experience. They work in the clinic with us; they talk with patients. They do outreach with us, too. And they provide us with feedback and help us see blind spots.
We’ve also started a mobile clinic. On alternating weeks, I take a van to the parking lot of Heart of Iowa, which is a substance use treatment program for pregnant and parenting people, and the Lary Nelson Center, which is part of the Department of Corrections. I see people who are there—we sit in the van--and figure out what we need to do to help them, and prescribe medications.
We also have active grants for two training programs: a one-year addiction medicine fellowship program for physicians and a one-year addiction training program for nurse practitioners and physician assistants. We graduated our first class of PAs and nurse practitioners in July 2024.
You see problems, you see gaps, you see injustices, and you want to find a way to do something about it. I'm happier doing what I do now than I've ever been. People go into health care because they want to help people, and I feel like these efforts are helping people.
