Justin Nielsen, executive director of Keizer's Renaissance Recovery, talks with case manager Katie King at the clinic's office. (KEIZERTIMES/Eric A. Howald)

Justin Nielsen, executive director of Keizer’s Renaissance Recovery, talks with case manager Katie King at the clinic’s office. (KEIZERTIMES/Eric A. Howald)

By ERIC A. HOWALD
Of the Keizertimes

Part of Justin Nielsen’s mission as executive director of Renaissance Recovery is meeting each client where they are.

The result is what Nielsen calls “cafeteria-style” offerings that allow each client to pursue their own recovery goals while drawing on many different paths to kicking substance abuse habits.

“The old way of thinking in the field was that treatment clinics wanted clients to adapt to them and their beliefs and processes, like being exclusively 12-step or something developed independently,” said Nielsen. “Even though I support 12-step, there’s other subgroups out there that respond better to alternative treatments that didn’t used to be available.”

At Renaissance, a client might choose SMART Recovery, a science-based treatment program, or Celebrate Recovery, which takes its guidance directly from biblical teachings, or some combination of the two.

Regardless, Nielsen tries to stay on the cutting edge of what’s available to those struggling with addiction, which is what led him to rolling out a new opioid addiction treatment program that include buprenorphine, more commonly know by the brand name Suboxone.

The program is only two months old, but it’s grown to include nearly two dozen clients, some of whom are driving from three or four hours away.

“I underestimated the need, and there are fewer buprenorphine prescribers than ever,” said Neilsen.

Buprenorphine is an alternative to the methadone for opioid addiction, and while the two drugs share a number of side effects, buprenorphine causes less sedation. Both drugs work by dampening opioid receptors and lessening the craving for the high induced by heroin or opioid pain-relievers like hydrocodone and oxycodone.

Becoming a buprenorphine  presbscriber can result in added costs for a doctor. It can mean paying more for liability insurance and costs related to support, tracking and accountability, which Nielsen said seemed to be the primary reasons for the low number of doctors willing to take it on.

Conversely, the partner doctor at Renaissance Recovery is nearly tripling the number of his available buprenorphine prescriptions with the onset of the new year (2017).

The goal with each new client is to work toward full recovery in about a year on average, Nielsen said. Clients enrolled in the program receive a prescription for buprenorphine along with a variety of support services to aid recovery efforts. For the first two months, new clients must check in with the doctor every week, and then less often as the dose of the drug is gradually reduced.

The support side of recovery is where Nielsen feels Renaissance Recovery is poised to make the biggest impact.

“We’ve started seeing an even more diverse group of clients. In the past it was what some people would see as the stereotypical addict or repeat DUII offender, but now it’s people who got in a bad car wreck, were prescribed Vicodin and have since moved on to heroin or other substances,” he said.

Other societal changes have also led Nielsen to change the way Renaissance does business.

“We’ve embraced technology because we found many of our clients were willing to. Every client that comes in can sign into our secure website and they can send messages to their counselor, find out meeting times and topics at our site and tap into other available resources,” Nielsen said.

Progress in the ways addiction is thought about – and treated – have also had an influence. Traditionally, recovery programs viewed abstinence as the only route to health, but Nielsen said the industry is moving toward a harm reduction model. Rather than trying to hold clients to pledges of going cold turkey, it might mean coming up with new parameters when they are using controlling substances – like not drinking alone, or not injecting drugs.

“I always think what we do is a taboo subject and a lot of people don’t want to admit how big the problem is. We’re trying to take a leadership role in recognizing the problem and meeting it,” Nielsen said.

The success of the buprenorphine program and other have led Nielsen to increase the number of employees on site and expand the hours of some existing employees.

For more information about programs available at Renaissance Recovery, visit renaissancerecoveryresources.com, or call 503-304-4358. Renaissance Recovery partners with more than 20 insurance agencies and is part of two coordinated care organizations that qualify for the Oregon Health Plan.