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May 6, 2025 15 mins
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Isabel Byon (00:00):
The New York State Office of Addiction Services and
Supports, or OASAS, providesthis podcast as a public service
.
Opinions expressed do notnecessarily reflect those of the
agency or state.

This is Addiction (00:11):
The Next Step.

Jerry Gretzinger (00:21):
Hey everybody, Jerry Gretzinger, your host for

Addiction (00:23):
The Next Step here, brought to you by the New York
State Offices of AddictionServices and Supports, and if
you've tuned in and checked outour podcasts in the past or if
you've watched the videoversions on YouTube, you know
we're in a different space today.
We're actually on location,because what we're doing this is
something that we're reallyexcited to do and it's to share
some of the good work that'sbeing done with the opioid

(00:45):
settlement dollars.
I'm sure people are familiar atthis point with the opioid
settlement funds the moneythat's come in to states around
the nation to help with theopioid crisis, the overdose
crisis, and there is a lot ofgreat work that's being done
with those dollars, and today weget to explain one of the many
things that that's helping tosupport.
And joining us today to talkabout this program we're going
to profile are Regina Hernandez.

(01:07):
She is here.
She's the Network Director ofAddictions Programs with the
Westchester Medical Center.
We appreciate you sitting downwith us.
We also have Lauren Taliaferro.
Taliaferro right, LaurenTaliaferro, there's a lot of
syllables in that second one,I'll make sure I get it right.
But you are a social worker whoworks with the program.

(01:28):
So, ladies, thanks so much forsitting down with us today.
So we are, we're here at theWestchester Medical Center and
we're talking about somethingthat's called a low-threshold
buprenorphine program, and I wasmentioning to you before we
started recording that I thinkfor those of us who work in this
area, we say the words lowthreshold buprenorphine and we
know we just say, oh, it's lowthreshold bup.
Okay, we understand.

(01:49):
But I think for a lot of peopleout there I mean, there's so
many different types oftreatments and avenues people
can take when they're lookingfor help with a situation like
this, they may go, yeah, okay,it's not the treatment.
But so let's start before wetalk about the specific program
here.
What does that mean?

Regina Hernandez (02:04):
When we say low-threshold buprenorphine, so
what that means in a nutshell isproviding easy access to
services, not only low-thresholdbuprenorphine but other forms
of MAT outpatient treatment,recovery services.

Jerry Gretzinger (02:20):
MAT medication-assisted treatment.

Regina Hern (02:20):
Medication-assisted treatment, yep.
Basically meeting people wherethey're at, seeing what services
could benefit them.
Person-centered care.
Letting the patient person whois encountering us in the
program lead the discussion andhelp them navigate what services
would work best for them.

Jerry Gretzinger (02:36):
And so by low threshold we mean that this is
like an easy avenue for them tobe able to access this

Regina Hernandez (02:41):
Lowest barriers

Jerry Gretzinger (02:42):
Right.
And again for people who maynot know, because again we make
a lot of assumptions,buprenorphine is a medication
that that helps with thisaddiction to substances, if you
can just kind of expand on thata little bit

Regina Hernandez (02:54):
Absolutely.
So, buprenorphine is one of avariety of medication assisted
treatments that people use totreat their substance use
disorder.
People utilize buprenorphine inmany formats.
There is the popular brand name, but also people can use it in
films, tablets, there isinjectable formulations of

(03:18):
buprenorphine, and basically ithelps people maintain their
recovery and a lot of peoplechoose that as their primary
form of treatment.
But they also might use that incombination with other forms of
treatment, such as if they'reneeding withdrawal and
stabilization services,inpatient rehab, outpatient
services, peer supports.

(03:39):
So it is not aone-size-fits-all.
It's very much tailored to theindividual's needs.

Jerry Gretzinger (03:45):
Right, I mean.
So obviously you know the kindof.
The key deliverable here is thetreatment with buprenorphine.

Regina Hernandez (03:50):
Mm-hmm.

Jerry Gretzinger (03:51):
But I think what is unique I think now that
this is becoming more I don'twant to say commonplace, but
probably more of a practiceddelivery is the whole low
threshold aspect of it, andLauren, I mean talk about that
being able to offer it lowthreshold right.

(04:11):
So basically, we're moving alot of the barriers that are
often in place of someoneaccessing this right.

Lauren Taliaferro (04:17):
Absolutely and to piggyback off of what
Regina was saying is, in thepast, buprenorphine, which is a
medication it's been hard to getit to the patient, so there
used to be many providers whowere not willing or able to give
the medication, and so there'sbeen a very direct focus to make

(04:38):
this easier for our patientsbecause, you know, if you have a
headache it shouldn't be sohard to get Tylenol type of
thing.
And that's kind of what theview is is how can we better
service our patients and ourcommunity at large?
This, unfortunately, issomething that is happening
across the country, and so it'sawesome that there is more of a

(05:00):
push to improve education,improve, you know, kind of the
treatment that our patients arereceiving, because we understand
there's been a lot of it justhasn't been the way it should
have been.
So part of what I do here atthe hospital is I work directly
in the ER and we have patientswho come to our ER looking for

(05:22):
treatment and that may beinpatient, whether they need
stabilization as they are tryingto get to that next part of
their recovery where they areabstaining and maintaining their
sobriety.
So patients come into our ERfor a plethora of reasons.
They may be looking for accessto services they may just have
questions of.
I've never been in thiscircumstance before.

(05:43):
What do the next steps looklike?
They may need medication tokeep them safe in that moment,
and so, inherently within thisproject and within this program,
low-threshold buprenorphinejust means get in here and let's
see how we can help you.
And so for some patients it willbe an admission to an inpatient
program, such as here at ourhospital, Westchester Medical

(06:06):
Center, specifically ourMid-Hudson Regional Campus.
For some patients, I will bereferring them to an outpatient
office where they can maintainthat medication and maybe also
receive counseling services.
For other patients, they mayjust need a listening ear and
some validation and someperson-to-person encouragement
of it is okay, you are not inthis alone.

(06:27):
And so we've been allowed tokind of, you know, really tailor
what we're doing to eachpatient's needs, because
everybody comes in and in adifferent circumstances,
everybody's life has lookeddifferently, and so we now have
the ability to treat ourpatients as such, whereas in the
past it was kind of a lot moreblanketed.

(06:48):
And so we've been given such agreat opportunity and we've been
seeing the effects of it.
We've seen a decrease in, youknow overdoses in our community.
We've seen patients coming inand being treated with kindness
and respect and in turn that hashad necessary and wonderful
effects again in our hospital,in our facility, but again also

(07:09):
our community at large.

Jerry Gretzinger (07:11):
All right, so I'm going to jump in there.
So I think it's.
I appreciate the breadth ofthat response because when I say
you know what is low thresholdbuprenorphine and how does it
help people, you went so farbeyond the explanation of what
buprenorphine does, right.
Because, that's the whole lowthreshold piece of it.
There is everything that youcould possibly imagine tied to

(07:31):
this.
It's making that connectionwith the people who need these
services, and I think one of yousaid whatever they need,
wherever they're at, we're goingto meet them, we're going to
help them.
Buprenorphine is just one pieceof that whole puzzle.
But to go back to that too, Ithink there's often people who
will say, okay, well, ifsomebody has been using a
substance, how does anothersubstance help them to kind of

(07:55):
break that connection right?
So I mean, I know, but I'drather have one of you explain
how it works for people at home.
So somebody comes in, they're acandidate for buprenorphine
treatment.
What does it do to help thembreak that connection, that
cycle they've been in?

Regina Hernandez (08:13):
So for many people it helps them maintain
what normality is for them anormal level.
So a lot of times the way Iexplain it is if somebody is
diabetic, right, they takemedication right to help them
maintain a healthy level.
Medication-assisted treatmentfor people with substance use

(08:33):
disorder is very similar.
They're taking medications notto replace one substance for
another, but to achieve a levelof normalcy for them, a level of
what makes them able tofunction at a comfortable level,
to live their lives, to have aquality of life, and whatever
that quality of life means is upto them, and we support that

(08:55):
with the services we provide.
So medication-assistedtreatment, in whatever form, is
meant to not so much replace asto support and enhance
somebody's quality of life.

Jerry Gretzinger (09:07):
And you know, I think too.
I think, now that we have thesetreatments available, they are
making such an impact.
And, Lauren, again I'm going togo back to you because I know
you have a lot of directinteraction with the folks who
come in here seeking this andbenefit from it.
What sort of and I think youwere starting to get at this
when I jumped in before but whatsort of changes are you seeing

(09:28):
in the people's lives who'vecome in and said, okay, I want
to do this, I want to make achange and have been able to use
this treatment to theiradvantage?

Lauren Taliaferro (09:45):
Yeah, so the first thing that comes to mind
is patients feel a lot moreinformed and like a participant
in their care.
So, based on the educationthey're given, they understand
exactly what this medication is.
To kind of speak to what youwere saying before.
Regina said it's not to replacebut to support and assist in
their recovery.
So they're tailoring so thesemedications do not necessarily

(10:05):
have like psychoactive you knowimpacts or anything to that
regard, but when patients comein, they are now able to know
exactly what's going on.
They have more of a voice intheir care of I do want this
medication or I don't want thismedication, or I want to go this
route, and so there's a lotmore independence and
involvement and because of that,you know again, we're seeing

(10:29):
that patients are feelingthey're leaving much more
satisfied and much more on boardwith their plan, and so that
means going forward.
You know, aftercare andfollow-up appointments are met
and, you know, maintained at amuch higher rate than they were
in the past.
Patients also, if they do falloff and we understand that can

(10:50):
sometimes happen on our journeys.
There's much less shame andjudgment when they do return to
us, and so they're able to say,Lauren, I fell off the horse.
What do we do next?
And we say, okay, today is anew day, you know, let's start
with where we're at.
So, again, it's given ourpatients and our staff an
ability to again be moreperson-centered, rather than

(11:13):
necessarily specifically focusedon treatment or medication or
something of that sort.

Jerry Gretzinger (11:18):
How many?
I mean, it's been what 14months that we've been doing
this program here, rightApproximately?
How many people you've seencome in and be able to take
advantage of this?

Lauren Taliaferro (11:29):
I alone have had about 700 encounters.

Jerry Gretzinger (11:31):
Wow, 700?

Lauren Taliaferro (11:33):
Yes, sir.

Jerry Gretzinger (11:34):
I mean that's a lot.
I mean we talk about the opioidsentiment dollars being broken
up over the state of New Yorkand what the good it can do.
700 people here in this oneprogram

Lauren Taliaferro (11:43):
Yes, sir.

Jerry Gretzinger (11:45):
That's terrific.
And the range of people comingin I'm sure all ages and
different walks of life.

Lauren Taliaferro (11:52):
All ages, so our specific program is geared
towards adults.
So I've seen 18 year olds, butalso up until we've seen people
in their 80s.
We've seen people fromdifferent demographics, as in
race, cultural backgrounds,religions, socioeconomic degrees
and statuses.
So literally no two patientsare alike.

(12:12):
But once again, once we're ableto get down to the nitty gritty
of the person and really, youknow, peel those layers back of
the onion.
A lot of our patients have hadsimilar circumstances, even
though they look different, andso again we're able to kind of
tailor you know what?
How specifically can we assistyou where you are in your life

(12:33):
and it won't look the same asthe next person treatment, and I
enjoy that about it.
It's very, um, very tailored.
But you would, you wouldcouldn't imagine.
Everybody in life has neededsome assistance and I'm glad
we're able to do it regardlessof the circumstances yeah,

Jerry Gretzinger (12:48):
And then 700 of them right now.
So far, that's in countingthat's in counting and so you
know.
Then, Regina, I'm going to popback to you too.
You know, one of the thingsthat we at OASAS are happy about
, we're proud of, is the amountof settlement dollars we're able
to get out as quickly as we gotout there some.
There are some states, forwhatever reason it might be,

(13:08):
they've had the dollars.
They're still waiting to getmost of them out the door.
Would this program be what itis without those settlement
dollars to help getting it tothis point?

Regina Hernandez (13:20):
Absolutely not .
I think that's why we'reincredibly thankful for giving
the opportunity to use thesefunds for low-threshold
buprenorphine, primarily becausehaving Lauren in the ED really
expands our outreach.
It allows us to touch morepeople in their greatest time of
need.
When we think about ourworkflow for how we plan to use

(13:41):
the low-threshold buprenorphineopioid settlement fund dollars
was really wanting to meetpeople at their greatest time of
need, which a perfect exampleis the emergency department.
People are coming in for avariety of reasons.
Primarily, a lot of ourpatients, because they know we
have an inpatient program, mightbe seeking services here, but
other people might haveexperienced an overdose.
Some people might just haveindicators that would make them

(14:04):
need substance use treatmentservices and and for that reason
we have Lauren in there.

Jerry Gretzinger (14:09):
So, yeah, so again, ladies, I want to thank
you for sitting down andchatting with us about this
today, Just one of the manyprograms these funds are helping
to support, and the differencethat it's making, that you are
helping to make, is justtremendous.
We're so excited to be able tobe a small part of what's
happening here, and you know.

(14:31):
Best luck for continued successwith this.
It's changing a lot of livesand that's amazing.

Lauren Taliaferro (14:36):
Thank you,

Regina Hernandez (14:37):
Thank you

Jerry Gretzinger (14:37):
All right, so listen this was a great
conversation we had today.
Hopefully it was informative foryou.
If you want to learn more aboutthe Opioid Settlement Fund and
the dollars that are available,what it's supporting, or you
just want to find out how youcan access treatment like this,
you can go to our website.
It's oasas.
ny.
gov, o-a-s-a-s, dot N-Y, dot.
G-o-v and, of course, if youwant to talk to somebody right

(14:57):
now, it's our hope line877-8-HOPE-N-Y.
877-8-HOPE-NY.
I'm your Jerry Gretzinger forAddiction: The Next Step.
Until we see you again nexttime.
Be well.
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