Here in Maine, SaVida Health has found its niche as a Medication-Assisted Recovery (MAR not MAT ) program where every substance use counselor is also trained and licensed in mental health.
About 160 members—members, not patients—have a SaVida Opioid Health Home in either Biddeford, Brewer or Calais. These are not homes that anyone lives in, though they have homelike touches, including cozy couches, houseplants, coffee makers and cell phone chargers. These “homes” are their member’s home base, made up of an entire recovery team, including peer recovery coaches, dually licensed mental health providers, and nurse practitioners.
All in one place.
“Every member is connected with the team, every week—until that member’s safety and recovery capital supports less contact,” said Abbie Rohde, Director of Behavioral Health for SaVida Health Maine. “Care continues to stay individualized, regardless of length of time in treatment.”
Recognizing that members are more than their substance use disorder diagnosis; recovery health is prioritized. For most members, this means addressing their co-occurring disorders, including anxiety, depressive symptoms, ADHD, etc., with a combination of individual counseling and medication.
“Scheduling and attending Primary Care Provider appointments, gaining employment and building informal support connections are also important components of the recovery health,” Abbie shared.
“Sober people have problems too, and our members have sober-people problems,” Abbie explained. “Not everything is a trigger for relapse, though time spent in isolation, combined with stress, grief and loss can increase a member’s risk of substance misuse. Having that connection, the support of a highly qualified and available support team can literally increase our member’s recovery capital and overall resilience.”
Shortly after this unique treatment model was developed [August of 2021], Abbie recalled a moment when a team member asked for support in knowing how to walk the line between holding members accountable for their actions and behaviors while also conveying support. This moment, specifically this question, birthed the concept of “compassionate accountability,” the very premise the program is built around.
“We recognize that our members have experienced trauma, and caused trauma. They have violated other’s boundaries and had their own boundaries ignored. The need to engage in dishonest behavior resulted in an instinctual desire to survive within a world of chaotic euphoria, sickness and despair.”
Abbie further explained that compassionate accountability encompasses a weekly urine screen, followed by an honest conversation around illicit use, danger, compulsion, science and human behavior. “Compassion without accountability, or vice versa, removes the human from the treatment model. Our members are more than their struggles,” she further elaborated, “however we also recognized that structure, especially in early recovery, is often the most effective intervention that can be provided.”
When asked to expand upon why SaVida Health is different than other treatment programs across the state, Abbie reflected upon the state’s significant effort to improve access to harm-reduction efforts, including increasing access to prescriptions, including Suboxone and Narcan, as well as needle exchange sites, as important steps in the fight to save lives.
“Our place in fighting this epidemic,” she shared, “is in healing generations. Our members are not seeking to order medication over the phone, live with internalized shame and stigma or simply reduce the risk of overdose. Members that walk through our doors are looking to repair relationships with loved ones and friends, regain custody of their children, experience personal forgiveness and recapture a meaningful and purposeful life.”