Family First Health’s Center of Excellence provides patients with substance use disorders the support they need to reach, and maintain recovery. Our team links patients to community resources/support services, then walks alongside each patient to ensure that critical needs are met and that the patient remains in care for as long as needed. The goal – to give each patient the supports needed to get, and stay healthy. The team is currently seeing patients at our George Street, Hanover, and Columbia centers. For more information please call 717-801-4864.

As I prepare for my day, I look over my list of patients and see a name that is unexpected. I typically see Mr. Jones three to four times a year for his blood pressure, which is generally under control. He is listed as coming in to discuss a “personal issue” with no other information. When the time of Mr. Jones’ appointment arrives, my nurse rooms him but is unable to gain any further information. When I walk into his exam room I discover to my surprise that he has brought a friend with him who talks first explaining that that his friend has asked him to come with him to support him as he tells me something. Mr. Jones goes onto to explain that he is using heroin every day and he wants help to get rid of this problem. He shares that as he works to provide for his family he is tired of having to keep using just to keep the withdrawal symptoms under control so that he can function. We go onto have an initial conversation about his struggles, how he ended up in this place of addiction and how he hopes things can change if he can be free of it. We then proceeded to get him setup for a more formal intake visit with myself and the Substance Use Services team to start him on buprenorphine and connect him with the various services we have to offer to support him in the recovery process.

Later I had the chance to reflect on this interaction and the various interactions I had experienced with Mr. Jones previously. Last October we began using a different screening tool for substance use in our patients at each visit. Since that time I had seen Mr. Jones on three previous occasions where each time he answered the screening questions denying any illicit drug use or misuse/overuse of prescription medications. Entering into this work of treating addiction in the context of primary care, I thought that these occasions would be rare, but there have been a number of them where existing patients disclose their struggle with addiction to drugs and alcohol. They, like Mr. Jones, have expressed that because of the relationship we had developed and then hearing that we were providing this service to help patients with addiction, they felt comfortable disclosing to me their history of use.

As a result of these kinds of experiences, I am convinced that integrating screening and treatment into primary care is key to addressing the current levels of opioid and alcohol dependence in our country. The relationship that exists with a primary care provider establishes a foundation of safety for disclosure for patients who want their lives to be different. By then utilizing this bridge created by primary care, behavioral health providers, and treatment facilities can experience more meaningful connections with patients resulting in improved outcomes.


Debra Bell, M.D.

Medical Director, Center of Excellence: a Substance Use Program of Family First Health

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