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The REACH (Recovery Enhanced by Access to Comprehensive Healthcare) Health Services program, directed by Vickie Walters, is a comprehensive outpatient substance abuse program uniquely designed to deliver medication-assisted treatment services to addicts in the communities where they reside. REACH originated as a National Institute on Drug Abuse (NIDA)-funded research project by IBR founder Dr. Joseph V. Brady in the early 1990’s, and was such a success that Dr. Brady and the late Carol Butler worked to transition the project into a full-scale clinical program. In 1991 the REACH program officially became a part of the IBR family and is IBR’s only currently active clinical services initiative. In 2011, REACH changed its name to REACH Health Services. REACH’s services include assessment and treatment planning, limited somatic care, pharmacotherapy, case management, referral, and counseling services. REACH uses an evidence based treatment approach called Responsive Step Care which matches the intensity of treatment provided to patients based on how patients are responding to treatment. Additional service provision is enhanced through a close collaboration with local health care providers. A full continuum of substance use disorder treatment services is provided in a cost-effective manner through the delivery of therapeutic services from centrally located site. The REACH program also expands access to care through the development of full service substance abuse programs or partnerships with existing psychosocial programs and their community service agencies in suburban/rural communities where services are not readily accessible. Methadone maintenance is the primary medication protocol utilized for the patients treated at the program. Currently, REACH also offers buprenorphine to recently released inmates from the Maryland Correctional Institute through a research protocol in collaboration with Friends Research Institute. Antabuse therapy and naltrexone aftercare protocols are available to patients as needed or requested and medical and psychiatric consultations are available as indicated. A medical history assessment, physical examination, serological work-up, and tuberculin skin testing are routinely performed on all admissions. Substance use detection is currently available through oral fluid, urinalysis, and blood alcohol screening/testing. All tests are administered and based on demonstrated need and in accordance with Federal Regulations governing the use of an approved narcotic drug in substance abuse treatment. HIV and hepatitis C testing are also offered on request and provided on site. REACH’s combined support from Baltimore Substance Abuse Systems, Inc. (BSAS) grants and HealthChoice and Primary Adult Care (PAC) program provides services to five hundred and fifty (550) patients. Services for all block grant slots funded by BSAS are limited to adult opioid-dependent persons residing in Baltimore city. PAC and Health Choice patients may be admitted from the surrounding counties in addition to Baltimore City residents. Patients admitted to treatment meet the diagnostic criteria for opioid abuse of dependency as set forth in the DSM-IV TR. in accordance with Federal regulations governing admission criteria for the use of an approved narcotic drug for substance abuse treatment. Further determinations are made, either through self-report or clinical assessment, as to whether the patient will be able to benefit from outpatient medication-assisted treatment services. No persons meeting Federal admission criteria will be denied admission based on race, religion, marital status, sex, age, ethnic origin, disabilities, or sexual preference. REACH was recently awarded a state licensure as an intensive outpatient program and provides a higher level of care to patients who are not doing well in standard outpatient or opioid maintenance therapies. The intensive outpatient service offers counseling 9 to 10 hours per week. Group counseling is offered 4 days per week and includes topics such as stress management, relapse management, trauma informed yoga, acupuncture, coping skills, health and wellness, compulsive behaviors, alcohol and stimulant education, in addition to many others. All patients are assigned an individual counselor and receive intensive individual counseling in addition to the group counseling. The small caseload size, fifteen patients to one counselor, insures individualized treatment services. Case management and psychiatric consultation and follow up are also provided. Patients with PAC and Health Choice from the community and from the REACH program are eligible for admission to the intensive outpatient program.
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