LEXINGTON Kentucky’s opioid-related deaths have been increasing steadily, with few signs of slowing. Though largely ignored before the last decade, the facts have grown irrefutable: Kentucky’s overdose mortalities exceed accidental deaths as we have become the third-highest state for overdose. Despite an onslaught of negative press and influx of mass-market drugs like fentanyl, opioid addiction remains a taboo subject in the Commonwealth, and at the expense of our patients. Open discussion and compassionate, proactive treatment could save lives. Two skilled physicians and business owners, Tuyen T. Tran, MD, MBA, and Marvin A. Bishop, MD, MBA, aim to beat the stigma and help Kentucky recover.
Tran studied medicine at the University of Missouri-Kansas City. His diverse training path guided him first to The Medical College of Wisconsin for his orthopedic surgery residency and later to the University of Kentucky Medical School in Lexington to study internal medicine. His endless ambition and desire to learn the business aspect of the medical field prompted him to obtain an MBA from Regis University.
Tran, a Vietnam native, recounts his family moving to the United States after the Vietnam war and expresses profound gratitude for the educational opportunities America provided. “I felt an obligation to give back,” he says. He soon found his chance in addiction management. Tran now serves full-time at Lexington’s Veteran Affairs Medical Center.
Two Doctors on a Mission
Because of his work in emergency rooms and at the VA, Tran understood pain patients and their addiction susceptibility. Tran says, “In the past, soldiers were sent to battle with a pack of cigarettes. Later, those cigarettes became pain pills.” Tran observed these veterans grow from desensitization to their pain medication to addiction, and he decided to augment his skill set. In 2008, he branched out and soon obtained a board certification in addiction management. He is also board certified in internal medicine.
Bishop, a board-certified endocrinology and internal medicine specialist, works full time in Winchester, Kentucky, with his father, a dermatologist. He graduated from Kentucky School of Medicine in 1999. He also holds a MBA from the prestigious Kelley School of Business. Bishop has also served on the Legislative Committee for the Kentucky Medical Association.
Around the same time that overdose deaths outranked accidental deaths, Tran realized how urgently Central Kentucky needed a clinic. Both partners’ previous education and diverse experience in both business management and medicine prepared them for what happened next. Tran met Bishop while working at the VA Medical Center’s Emergency Services Department and approached him about the vision and partnership that became 2nd Chance Clinic.
A Different Kind of Addiction Clinic
In 2012, 2nd Chance Clinic opened its first Lexington location. “When we first started,” Tran says, “We had a tiny office and a tentative plan: We just wanted a place for people to get help.”
The clinic outgrew its confines and resurfaced in a 15,000 square foot facility with 12 intake offices. The facility now serves more than 1,400 adult patients and customizes an opiate addiction treatment for each. Recovery services can include physician visits, individual or group therapy, and targeted case management services. The clinic employs eleven physicians of various specialties and is open six days per week.
More Than Medicine
2nd Chance Clinic practices a customized medication-assisted treatment plan, or MAT, using drugs like buprenorphine and naltrexone. After a treatment period, many patients gradually taper off the drug; however, one constant remains for patients. They need more than medicine.
2nd Chance Clinic digs deep, implementing a two-tiered approach that combines psychotherapy with case management. “Consider ours a modified 12-step program,” says Bishop. “Patients receive counseling, including cognitive behavioral therapy, to resolve root causes blocking their recovery.” Through case management, 2nd Chance Clinic screens every patient to assess various needs, such as finances and transportation, and clear obstacles whenever possible. “After all,” says Tran, “if our patients are starving or indigent, they’re too preoccupied to receive treatment; then we’re back to square one.”
Addiction management specialists like Tran and Bishop, as well as cumulative National Institute on Drug Abuse research, remind us that addiction is a chronic, debilitating disease; chronic disease demands lifelong attention. “As with diabetes, you go to your grave with addiction. Our goal here is to stop patients from going to their graves because of it.”
Much like with traditional 12-step programs, addicts benefit from peer counselors who are in recovery and can relate to both their struggles and triumphs. The clinic continuously screens patients for any ongoing drug use to ensure compliance.
A Need for Community Support
According to Tran and Bishop, everyone surrounding the patient can aid their recovery. Addicts face challenges when they reenter the workforce. Often, they lack practical experience from missing high school and college. Many of them also carry drug-related possession charges, further limiting their career options. Tran continues, “This is what we need everyone to realize: We can stabilize patients through medicine and psychotherapy, but the only way we can overcome the opioid epidemic is with your help. This community has to welcome them back.” 2nd Chance Clinic collaborates with local charitable groups, such as The Nest and Jubilee Jobs.
Bishop urges families to take an active role. “Patients might feel uncomfortable seeking treatment and talking about their recovery needs at first, so a home support system is absolutely vital to a lasting treatment.”