Preventing Drug Overdoses with Medically Assisted Treatment in San Francisco
On August 31, GLIDE observes International Overdose Awareness Day in remembrance of those who have lost their lives to overdose. It is also a day to challenge the damaging stigmas associated with drug use and to elevate compassionate, effective approaches to overdose prevention. Deaths from drug overdoses remain shockingly high in San Francisco – 641 deaths were reported in 2021 and 2022 has already seen nearly 300. Sadly, overdose has been the leading cause of accidental death in California every year since 2011.
At GLIDE, we know that individuals and communities need a continuum of smart and compassionate strategies to help mitigate harms related to drugs and drug use. As a harm reduction service provider, GLIDE has recently begun providing Medically Assisted Treatment (MAT), an individually tailored approach to drug use that uses a combination of medication and therapy to help clients achieve their goals.
This Overdose Awareness Day, GLIDE sat down with MAT Resource Navigator, Maxwell Kitz, and Syringe Access Services Coordinator Ali Lazarus, to hear more about Medically Assisted Treatment.
Ali: First off, what is MAT?
Max: Medically Assisted Treatment is a form of care that helps people achieve their substance use goals, whether it is completely stopping their use of drugs, or using less with the assistance of prescription medications such as methadone, suboxone, or naltrexone.
Ali: Let’s take a prescription drug like suboxone. How is it being used?
Max: Suboxone is a medication that does several things. It helps prevent withdrawal by decreasing the cravings and it is a long-acting opioid, which means it can keep away withdrawal symptoms for up to an entire day. Because of the way it works, it binds tightly to your opioid receptors preventing other opioids from affecting you. It prevents overdose because there is no way for, say heroin or fentanyl, to get through the wall that it creates.
Ali: How is GLIDE currently implementing MAT?
Max: The MAT access program is made up of a partnership between us, the City’s Department of Public Health, and Bright Heart Health (BHH). We set up what we call the “MAT table” next to the Syringe Access desk on the corner of Ellis and Taylor St. I also do street outreach, visiting various neighborhoods where I can engage with folks where they are at. People who might be struggling with opioid addiction or any kind of substance use can approach me with whatever their situation might be. I use an iPad to fill out the intake paperwork for BHH and then I schedule a zoom with a prescribing doctor, all done via the tablet. The participant’s prescription is then sent to the pharmacy and within a few hours, their prescription gets filled.
Ali: How do you respond to those who might say that MAT sounds a lot like you are treating an addiction with a drug, and you are just replacing one drug with another drug?
Max: Withdrawal, being a severe and often dangerous process, is a huge barrier for people who are trying to transition off opioids like heroin or fentanyl. That fear keeps people from not being able to quit their addiction. MAT offers a smoother offramp than just quitting or going “cold turkey.” It gives you space and time to build a support network and to establish some stability. Many of GLIDE’s participants are either unhoused or do not have access to a lot of support. They appreciate having that stability.
Another wonderful thing about MAT is that you know what you are getting. When you are using street drugs, you do not know the amounts or what exactly it is you’re getting. With suboxone and methadone, you know exactly what you are getting because it’s prescribed by a medical professional. And, because you are getting it in a controlled fashion, you can taper off your usage and over time, slowly decrease your medication and experience little to no withdrawal symptoms throughout the entire process. We understand that people are going to use drugs and we want them to be as safe as possible, whether that means using sterile needles or methadone or suboxone or some other medically assisted treatment.
Ali: Are you seeing success stories in your outreach?
Max: Absolutely. I was speaking with a participant recently, who, since starting the MAT program, has found a new job, been able to obtain stable housing, and was able to attain their goal of stopping use. Thanks to MAT, this person, through their own power, was able to achieve these things and it has been life changing for them.