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Local Community Group Finds Common Ground with the Nation's First 24/7 Opioid Treatment on Demand (OTOD) Clinic


Leticia D'Amore, ORN prevention consultant

In response to a request for technical assistance, the Arizona Opioid Response Network team helped the nation’s first 24/7 Opioid Treatment Program (OTP) in Phoenix, Arizona form a collaborative working relationship with a local community task force to have the program located in their community.

The OTP, operated by Community Medical Services (CMS), over the past years has tried to form a working relationship with the community, some of whom had concerns about the program being opened 24 hours, seven days a week.

Then, in November 2018, Shana Malone, the Clinical Initiatives Project Manager in the Office of the Director at the Arizona Health Care Cost Containment System (AHCCCS), made a request to the Opioid Response Network asking for help facilitating an open dialogue between the two groups in an effort to support change.

Benjamin Nguyen, MSW, the Technology Transfer Specialist for the Southwest region of the U.S., conducted a need assessment with Ms. Malone and learned that the State had been very responsive to the community's concerns, but had limited bandwidth to carry out other statewide opioid-related projects as it appeared there was a great amount of time invested into neutralizing and managing tensions from within the community. Despite providing information and evidence about the science and data about medications for addiction treatment (MAT) and evidence based practices , the community had been proactive and persistent at rallying individuals together to express their disapproval and skepticism towards the OTP’s operations in their community.

Hopes were not high for either side that the two groups could work together and find some common ground until Leticia D’Amore, MSW an ORN prevention consultant, began attending their meetings.

The Neighborhood Preservation Task Force was concerned about increased traffic and that the program’s clientele was directly tied to homelessness, loitering, crime, and other safety concerns in the area; and felt that having the program open 24 hours would only increase negative effects.

D’Amore realized she needed to come into the situation as a neutral party, listening to the concerns both sides expressed in hopes of clarifying information and developing a strategy of mutual respect and understanding. The vast majority of those on the task force were supportive of CMS, she noted, and getting the community to—not only stop opposing the OTP but—support it was an overarching goal. It was also important that those on the task force understand that the OTP wanted to be involved in the community and to be seen as a positive influence.

“Throughout the whole process I served as a connector between the task force, the community and the clinic. It was always about building trust,” D’Amore said.

Through several meetings with the community and the task force, slowly that trust began to grow. CMS meets with the task force every other Friday—meetings that have become much more productive and less contentious. “We do the work in a hope that everyone will align in a way that is productive,” D’Amore said. “I want to underscore the significant contributions of and flexibility of this provider and those of the community. When I arrived, tensions were high and emotions were strong.”

“We put tireless efforts into not just existing in our community but being a thriving part of it,” said John Koch, CMS Community Impact Manager.

Nick Stavros, CMS CEO, said the provider, with 28 clinics throughout the nine states in the western half of the country, has a blueprint it follows when it is going to open a new clinic. CMS meets with local police and officials, holds meetings and open houses, and provides training so people understand what MAT is. The community always has concerns, which are mostly addressed through this process with positive outcomes, he said. But in the case of this particular Phoenix location, CMS needed more help.

Mr. Koch had been working with the task force, prior to ORN’s involvement. “A big shout out to Leticia, because I don’t know if we could have ever gotten here without her and thanks to SAMHSA for providing this resource,” Koch said. “Now we go to these meetings and it’s more of a discussion of how we can help the community as a whole. Leticia came in and helped the community to understand. She also empowered us as a provider. Without Leticia, SAMHSA, and ORN being involved, I don’t know if we would be where we are today.”

D’Amore not only praised CMS—particularly Koch for his commitment to finding a resolution—but also Ben Nguyen, the Technology Transfer Specialist assigned to the request. “I needed a certain level support, and the person I would always turn to was Ben.”

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In response to the nation’s opioid crisis, SAMHSA awarded a two-year grant and created the Opioid Response Network (ORN) to enhance opioid-related efforts already underway throughout the United States and territories. ORN, led by the American Academy of Addiction Psychiatry (AAAP) with a coalition of 27 national professional organizations, provides training and technical assistance via local experts across the country, focusing on applying evidence-based practices in prevention, treatment and recovery to meet locally identified needs. If you need technical assistance, please submit a request here.