From the homeless to high-functioning executives, addiction to painkillers doesn’t discriminate. “Roughly 120 people die a day from opioid overdose,” said Tuyen Tran, M.D. “Opioid addiction is killing more people than motor-vehicle accidents.”
Tran is board-certified in internal medicine and in addiction medicine. His business partner, Marvin Bishop, M.D., is board-certified in internal medicine and endocrinology. Both have practiced emergency medicine. In 2012 they opened 2nd Chance Clinic to address opioid addiction. Previously on Buckhorn Drive, the clinic owners purchased a building on North Broadway last March and moved into the 15,000-square-foot space in late summer. The outpatient facility has 50 employees on its medical staff, including doctors, counselors, case managers and lab staff. “We see 1,500 unique patients a month,” Tran said. “We believe people deserve a second chance.”
Tran traces the opioid epidemic back almost three decades. “In the ’90s, the stamp of society was that we, as a medical profession, were inadequately treating people’s pain and unnecessarily causing suffering,” he said. While relieving pain is a noble intention, Tran said it became obsessive. “I saw a significant shift from patients who needed pain management to patients who wanted to be pain-free.” As a fairly new field of medicine, treating addiction didn’t have many standards when 2nd Chance Clinic opened. “It was the Wild West,” Tran said. “Everybody was trying different ways to treat the problem.”
Susan and Marvin Bishop, left, with Tuyen and Lynh Tran at the ribbon-cutting for Second Chance Clinic
As physicians, Tran and Bishop’s goal in the beginning was to stop withdrawal symptoms and stabilize the patient with medication-assisted treatment. They chose to use buprenorphine instead of methadone for two reasons—less red tape for both clinicians and patients, and evidence suggesting that buprenorphine was a more effective treatment.
Before long, the clinic owners realized the medication was treating only one aspect of the problem. “We recognized the need for counseling,” Tran said. He knew that counseling by itself didn’t seem to work very well for addiction, but a patient stabilized with medication first would be able to “receive the counseling much more than if they were preoccupied with cravings.”
Their next objective was to maintain treatment and to support patients in staying clean. “This is the part that needs to be emphasized,” Tran said. “Regardless of how well I think I know my patient, nothing speaks better than a drug screen that says, yes, there is nothing else in his system.”
Continuing to track patients’ progress, 2nd Chance Clinic also introduced support to help patients take care of basic needs and reintegrate back into society. “Regardless of what we do, if the patient needs shelter and food, they’re not going to pay 100 percent attention to what we’re trying to offer,” Tran said. They brought in case managers to assess and assist with homelessness, transportation and domestic violence. They’ve also partnered with Jubilee Jobs of Lexington to help patients find employment and with The Nest Center for Women, Children and Families.
“We’re now entering the last area of addiction that has not received any attention,” Tran said. “We are going to start looking at how to address the chronic pain.” 2nd Chance Clinic is exploring the psychotherapeutic technique called EMDR, which stands for Eye Movement Desensitization and Reprocessing. “We’re hoping to use EMDR to block the triggers that create the trauma associated with chronic pain and the need for pain relief,” he said. His team is also starting to look at yoga, core-strengthening exercises and proper nutrition.
“I don’t want to see clinics that offer just the medication. I worry about the consequence of making buprenorphine the only treatment. It’s designed to alleviate withdrawals, because of the pharmacology,” Tran said. “I wish we can adopt a standard whereby you must offer the comprehensive package.”