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The state of California is implementing a new program for treating those with opioid use disorder (OUD). With heroin and prescription drug addiction increasing, along with overdose deaths, the new Hub and Spoke System (H&SS) will focus on medication assisted treatment (MAT) as a means to reverse these trends. Specialized addiction centers will act as Hubs for offices or clinics with buprenorphine prescribers, or Spokes.

H&SS is projected to serve over 20,000 individuals in a 2-year period.

Access to treatment has been a barrier for addicts wanting to get clean. In many cases this is because there is no place to get treatment anywhere nearby. In rural areas, one may need to travel over 100 miles every day for a dose of Methadone or buprenorphine until they qualify for take-home doses. It’s discouraging, and most addicts will use rather than go to the trouble.

Another issue is the lack of prescribers available even in metropolitan areas. Medications used for MAT services are tightly regulated for obvious reasons. While it’s important to ensure that these medications are kept off the streets, the result is that most MD’s have not been willing to go through the process of getting licensed. The stigma of addiction in some localities also may influence their decision to be licensed to treat the disease.

With H&SS, offices closer to and in rural areas (Spokes) will have the ability to refer patients to their Hub center for MAT services. Spoke offices and clinics will have at least one registered nurse and one licensed clinical social worker on hand to then provide local services like prescribing, dosing, and case management. This alone will make opioid treatment accessible to a greater number of individuals that need it.

Thanks to the passage of Assembly Bill 395, narcotic replacement therapy is mandated for treatment through the Department of Health Care Services. Coupled with Senate Bill 554, which allows Nurse Practitioners to furnish and order buprenorphine and allows Physicians Assistants to administer and provide it under a licensed physician’s supervision, more offices and clinics will determine that it makes sense to provide the services. They will have reason to be Spokes for their communities.

To be clear, H&SS makes it possible for opioid addicts to get treatment closer to where they live. Their Spoke may not be in the same town, but it will be more local than the next metropolitan area. They also have access to addiction professionals by way of the Hub. All of this reduces resistance to treatment because they can get to a location daily to receive a dose of buprenorphine.

Tarzana Treatment Centers will act as a Hub in our region for H&SS. We’ve been conducting telehealth sessions and providing treatment for clients in other counties, so we’re well-prepared to get started. H&SS is a little different, and it’s exciting to be a part of this large-scale effort.