A new group, VOCAL-NY, modeling themselves after some of the aggressive organizations that brought attention to the AIDS crisis in New York, is focusing their attention on methadone maintenance treatment in opioid treatment programs (OTPs). Last year, a group of VOCAL members went to the state capitol to get the attention of Gov. Andrew Cuomo about hepatitis C testing and treatment in OTPs. To their surprise, the Office of Alcoholism and Substance Abuse Services (OASAS) was responsive, supporting the need for a more comprehensive hepatitis C program in OTPs, where many patients are infected with the virus. OASAS medical director Steven Kipnis, MD, “got it immediately,” said Sean Barry, a leader of VOCAL, which stands for Voices of Community Advocates and Leaders.
VOCAL has been critical of some OTPs. The organization advocates for improved treatment, transparency, knowledge, and education. In particular, the group says patients should have better testing and treatment for hepatitis C, a major concern for VOCAL-NY members. Treatment should be provided on site, says Mr. Barry, citing a model used at the Albert Einstein College of Medicine. On-site treatment is important because many patients do not follow through on their own, and patients can benefit from peer and staff support.
There is some confusion about what is required by the state. According to Vocal-NY, all patients should be screened upon admission to an OTP and at yearly check-ups. Asked what the current OASAS regulations are for OTPs and hepatitis C, an OASAS spokeswoman responded: “OTPs are required to test for Hepatitis C, if clinically indicated.”
But as a result of VOCAL-NY’s efforts, OASAS is in the process of developing additional guidance to assist OTPs in working with patients with hepatitis C, said the OASAS spokeswoman. That guidance was due February 9.
For the report from VOCAL-NY, compiled by surveying OTP patients, see http://www.vocal-ny.org/publications/beyond-methadone-improving-the-health-of-patients/.