East metro tests rapid response for addiction treatment

A year ago, nearing the bottom of a lifetime of alcohol abuse, Tito Reyna checked himself into St. Joseph's Hospital in St. Paul after being jailed during a drunken episode.

Today, the chef's mind is on the tamales he needs to make for the holidays and his son's Christmas toy list, rather than the alcohol that fueled his past, and he credits a new program called Mobile SUDS (Substance Use Disorder Support) for providing help he never had before.

"To wake up in the morning and look in the mirror and say to yourself, 'You're doing good, you're doing good' — wow," the 48-year-old said.

SUDS was created one year ago by east metro health care leaders who recognized that the existing substance-abuse treatment system had a gap between the emergency supports of hospitals and detox centers, where patients wound up in a crisis, and the outpatient and residential recovery programs that have waiting lists. Patients often lacked immediate help at the crucial moments when they decided to ask for it.

SUDS consists of all-purpose counselors and peer support workers who help patients in recovery by talking with them on the phone when they have cravings, instructing them about insurance benefits, driving them to group recovery meetings, and meeting with them for regular check-ins in comfortable settings. Reyna likes to meet with the counselors near the fireplace at his favorite cafe in Stillwater.

The desire to overcome addiction can be ­transient, and treatment programs often miss that window before people abuse drugs or alcohol again, said Roger Meyer, project director of the East Metro Crisis Alliance, a group of health care leaders that seeks to address gaps in local health care.

"What we've created with this program is the persistence and presence, so that when they're ready, they don't have to wait," he said. Until now, he said, "they would have been left waiting for four weeks [for space in a treatment program]. That's a lot to ask."

SUDS workers then meet with the patients in person, which is key because patients usually only receive pamphlets about substance abuse treatment when they leave hospital care, said Dayne Bartlett, a clinical social worker leading the SUDS program.

Reyna said that hospital visit was influential because it was from someone "like me" who told her own addiction story and earned his trust. "That meant a lot," he said, "because to open up to somebody is the hardest thing."

Raised in foster homes, Reyna started abusing alcohol as a teenager. While he has been in hospital and residential treatment programs before, he said he often felt like he was only going through the motions. One facility didn't discuss his treatment plan until day 21 of a 28-day stay.

SUDS' support and counseling supplements the medication and therapy that people receive for addiction. Bartlett said he uses aspects of dialectical behavior therapy, or DBT, in his visits with Reyna to help him learn how to cope with the trauma and neglect he experienced as a child.

Patients in SUDS also have joint family outings such as trips to a zoo. Bartlett said the group activities help patients form closer bonds with their families and with one another, which can protect them from relapsing.

Meyer said the coalition hopes to prove that the SUDS strategy works and to persuade insurers and businesses to pay for it.

While patients' long-term recovery is the goal, the short-term success of the program is being measured by its ability to reduce costly ER visits and hospital admissions. Roughly 100 patients have participated in the past year, and about 34 have committed to the program through visits and contacts with SUDS staff for at least three months.

Twenty-five of those patients made 70 ER visits in the six months before they entered the program — both for substance abuse treatment and general medical needs. They have made only 25 visits since enrolling. Nine participating patients have seen no change in ER usage, though.

Reyna said he's learning to cope with his childhood neglect, and with things he said and did to others when he was drinking that he can't take back.

"It eats me up inside," he said.

"I'm always aware of the cravings," he said. "I just know how to deal with them."

jeremy.olson@startribune.com 612-673-7744