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Q&A with Dr. Catharina Armstrong, Spectrum’s Newest Medication for Opioid Use Disorder Program Physician in our Correctional Division

Between opening new centers and engaging in new contracts, we’ve been lucky to welcome a number of doctors, nurses, clinicians, counselors and senior leadership over the past several years. Today, we’re welcoming Dr. Catharina Armstrong, Program Physician for Spectrum’s Medications for Opioid Use Disorder (MOUD) Program with the Massachusetts Department of Correction (MADOC). Dr. Armstrong is board certified in addiction medicine, internal medicine and infectious diseases.

Spectrum’s work with correctional facilities in Massachusetts and beyond has enabled us to provide individuals who often struggle with substance use disorders (SUDs) with life-changing and evidence-based treatment. We sat down with Dr. Armstrong for an inside look at her work with patients in correctional settings, the current state of addiction, and her thoughts on the ongoing COVID-19 pandemic.

What brought you to Spectrum?

Over the years I have worked in the areas of addiction and infectious disease in a variety of settings, including correctional facilities, hospitals, outpatient clinics and prisons. I was working as an addictions physician and Chief of Infectious Disease at Lemuel Shattuck Hospital when I was offered the position of HIV provider for inmates at MCI Framingham. This position was later expanded, allowing me to practice as both an HIV and addictions physician.

When Spectrum arrived to help treat offenders struggling with addiction, it opened up many more options for our patients. Before, we had limited medications for opioid disorders – just naltrexone and buprenorphine. Now, we’re able to offer methadone, buprenorphine-naloxone, and naltrexone. Having methadone as an option has filled a huge gap in care. Because Spectrum is so specialized in addiction treatment, we can really focus on that issue and utilize our continuum of care to provide the best medical therapy for each person. In this way, Spectrum is truly groundbreaking and ahead of its time.

What has your experience with patients been like during COVID-19?

In addition to my work in corrections, I am the associate director and co-founder of the Substance Use Services (SUS) Bridge Clinic at Newton Wellesley Hospital (NWH). During this difficult time, we never shut our clinic and in fact we increased overall volume. Telemedicine has been an invaluable tool for us to connect with patients during this vulnerable period. Since COVID-19 hit, we’ve seen a significant increase in mental health issues and substance use disorders (SUDs). It is quite literally a pandemic within the pandemic. Outpatient consults have skyrocketed because individuals are struggling, and telemedicine has given patients a way to access care.

COVID has also brought in people who may be struggling with SUDs for the first time. While pandemic-related anxiety has intensified, causing increased substance use and relapses, this time has also brought about improved access which I think will continue well after the pandemic. We need to accept telemedicine as a permanent resource, especially for people who can’t get to a clinic for a myriad of reasons. The only silver lining here may be the fact that with COVID we have learned other ways to engage patients and how to do it in a compassionate way. Overdose rates decrease when we can reach more people, both in person and with telemedicine. Patients don’t have to wait for an in-person visit with this option, and they shouldn’t have to die waiting for lifesaving medications to be prescribed or for an appointment in a clinic.

The isolation secondary to the pandemic has been devastating to our patients’ ability to maintain recovery and they have been so appreciative that our clinic has remained open if they did choose to meet in person -- whether it’s to have their first visit, get their naltrexone injection or simply engage in therapeutic supports in person with multiple caregivers which has been so difficult this past year.

What kinds of topics are trending within the addiction medicine community?

Alcohol use disorder (AUD) has become a forgotten part of addiction since the increase in opioid use disorders, big pharma prescription opioids, fentanyl and more. AUD is still a leading cause of death in the U.S. and long-term alcohol use is rampant. AUD related deaths still trend higher internationally than opioid related deaths and, most recently, we’ve seen increasing rates for women.

COVID-19 has also created this perfect storm for increased alcohol use, binge drinking, and AUD. While many have fallen into this trap, awareness for AUD is rising. We’re now recognizing that telemedicine in combination with in-person visits can help treat this disorder and we’re able to reach more people this way.

Overall wellness has been a big concern during the pandemic as well. Things people used to do on a daily basis, such as biking to work, taking walks with friends, and attending exercise class, have mostly come to a halt. As a result of being isolated at home without access to healthy outlets, many people have resorted to drugs and alcohol to ease their anxiety. People report using substances to cope with COVID related stress. I’ve been working with patients to introduce or re-introduce a variety of wellness activities.

We pride ourselves in selecting top talent to work across all of our departments, creating a family with the same mission: to treat as many people struggling with addiction as possible. We’re thrilled to have Dr. Armstrong join the Spectrum team, providing clients with the best possible care.

For more information about careers at Spectrum, visit our website for current openings.

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