Q&A with Gateway Rehab COE Patient

What follows is a Q&A with the first patient of Gateway Rehab’s Opioid Use Disorder Center of Excellence (COE).  One of 50 recognized Center of Excellence in Pennsylvania, Gateway Rehab treats those suffering from opioid use disorder and provides specialized and coordinated care for individuals with Medicaid.


What brought you to Gateway Rehab and the COE?  

Today, I’m happy to say that I’m totally clean and sober for 15 months.  I am a miracle.  But my life before entering recovery for the first time progressively fell apart because of my drinking and using drugs.  

I am an alcoholic and drug addict, but I always had excuses for not seeking or asking for help: I didn’t have health insurance, or I didn’t want my employer to know.  But, I finally had the courage and humility to ask my family for help and they were right there for me.  My sister contacted a friend, who contacted Gateway Rehab.  

My memory is a bit hazy about this particular part, but I was admitted into Mercy Hospital in November of 2016.   I am quite certain that it was the Gateway Rehab Center of Excellence (COE) that helped me and my family through this part.  They got me into detox with no health insurance and I was there for I believe seven days.

Mercy detoxed me from the alcohol but not the methadone I was also dependent on.  After detoxing from alcohol at Mercy, a driver from Gateway Rehab picked me up and I was taken directly to Gateway’s detox.  I did not have to arrange any of this myself; Gateway’s COE arranged it all.  

What was your experience like at Gateway?  

So, when I arrived at Gateway I was a total mess, so terribly sick and broken.  I realized I was way worse than I initially thought.  But everyone was so very warm and welcoming, and I remember being told that I was the first patient to go through the Center of Excellence program.  

I believe I was in detox for seven days and then inpatient for almost a month.  My counselor, Mark, made me feel comfortable and not so alone.  Immediately, he suggested a halfway house and I believe, at this time, I was a little resistant.

As the days went by, I was really struggling.  I sometimes shook so much I could hardly feed myself.  I saw Dr. West a couple of times, but I mainly saw Dr. Capretto, who never quit on getting me better.

About halfway through my stay at inpatient, Shannon from the COE came to meet me.  She was pleasant and encouraged me to go to CeCe’s Place, Gateway’s halfway house for women.  I took her suggestion.

It was another smooth transfer to CeCe’s Place, thanks to the COE.  This is where my real healing began.  All of the women there were amazing.  I learned so much about myself in a short amount of time.  Yes, trust me, looking back now, it’s like a blink of an eye and was necessary.  With the help and support of many at Gateway and the women at CeCe’s Place, I learned how to live sober; I surely didn’t know how to before.

I left CeCe’s and went back to Pittsburgh to stay in an awesome three-quarter house.  I also enrolled in Gateway’s intensive outpatient program.  I went back to work, stayed accountable, and shared my thoughts and feelings.  I believe I was at the three-quarter house for six months.  

During this time is when Janice was designated as my personal recovery specialist by the Gateway COE.  She has been undeniably an essential part of my recovery.  She called weekly, sometimes daily, and visited me countless times.  She also helped me with my insurance, to make and get to appointments, and accomplish other things that I haven’t wanted to but had to do for my recovery.  Janice was always there for me and helped keep me accountable.  

What did you learn about yourself throughout this process?

I learned that I have had anxiety my whole life, even as a child.  I learned that I can’t expect people to know what I’m feeling if I don’t tell them.  I learned that I lied all the time, simply because I didn’t know how to put my feelings into words.  I learned that I was in an abusive relationship.  I learned that I have a messed-up sense of obligation that has kept me stuck.  But most of all, I learned how to cope with all of this.  Before entering a life of recovery, I didn’t have one coping skill my entire life besides drinking and using drugs. 

How has your life changed since leaving Gateway Rehab and living a life of recovery?

So, finally, I am out in life all on my own.   Since being back to work, I have received two promotions, an all-expense paid transfer out of state, and a rent-free furnished apartment. I am a productive member of society.  I know … miracle!  

And, through all of this, Janice has always been there for me.  She has visited me three times since I moved out of state.  I have a suspended driver’s license, so, this has been so helpful.  With her in recovery as well, her help is unparalleled.  She has always been and, I believe, will be readily available to me.

I am eternally grateful to Gateway Rehab and its COE for helping guide me through this journey.  The promises are real, and I realize them every day.     

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Q&A with Center of Excellence Recovery Specialist

What follows is a Q&A with Recovery Specialist Janice Olson from Gateway Rehab’s Opioid Use Disorder Center of Excellence (COE). One of 50 recognized Centers of Excellence in Pennsylvania, Gateway Rehab treats those suffering from opioid use disorder and provides specialized and coordinated care for individuals with Medicaid.


What is a Center of Excellence?

Gateway Rehab’s COE is administered through its Care Coordination Program, which helps to ensure that people with opioid-related substance use disorders have access to treatment and may receive follow-up care and support from their communities. The Care Coordination team puts comprehensive recovery plans into action for people who are uninsured or receiving Medicaid. Care is team-based and “whole person” focused, with the explicit goal of integrating behavioral health and primary care.

Who is eligible and what services can be expected?

Anyone who is diagnosed with an opioid use disorder and is uninsured or receiving medical assistance. A person does not have to be receiving treatment from Gateway Rehab.

Along with comprehensive care management and coordination, a person will receive transitional, follow-up care for one year, family support, referral to community and social support services, and, peer-to-peer support from certified recovery specialists.

What is a certified recovery specialist?

Certified recovery specialists (CRS) are individuals who have completed specialized addiction training from a state accredited school or institute, and who have passed the state examination for certification. We are in long-term recovery and work with drug and alcohol patients on a peer-to-peer basis. The primary function of the CRS is to help individuals gain access to needed resources in the community by assisting them in overcoming barriers and bridging gaps between their needs and available resources. As a CRS, I use unique insights gained from my own personal recovery experience, plus skills and knowledge learned from earning my state certification. As such, I meet my patients where they’re at; I have a sense for what they’re going through and can help empower them to make better, healthier decisions.

What does a CRS do?

Once enrolled into the COE, an evaluation of needs is completed for each patient. I then help them prioritize their needs based on what needs immediate attention. Usually, a patient’s immediate need is for treatment and housing, but we also help them connect with a primary care physician, mental health providers, and other substance use disorder treatment providers.

If a person is ready for treatment, I review the options for treatment with them and, upon completing treatment, I help them make a decision about transitional housing that will support their recovery, such as a half-way house, three-quarter house, and or other appropriate housing.

How else can a CRS help?

There are times when a patient has never been to a 12-step meeting before and taking them to their first meeting helps to break the nervousness or stigma about 12-step fellowships. I do want to stress, though, that a CRS is not a 12-step fellowship sponsor. A CRS helps a patient overcome barriers and bridge gaps between their needs and available resources within the community. For instance, many of my patients don’t have a vehicle or a driver’s license and need help with transportation. I can help them sign up for travelers’ aid and also help them get to know the bussing system within their community. Also, some of my patients have criminal charges pending stemming from their drug use. I may go with patients to their legal hearings and advocate for them … helping to break the stigma.

How often do you meet with patients?

We will meet with our patients at least once a month for a face-to-face to see how they are doing and help them connect with any resources that they may need; however, we’re always just a phone call away.

We also are responsible for obtaining monthly drug screens from our patients and, if a patient does prove positive for any drugs, we will help them seek treatment if they are receptive to receiving treatment. We always want to let our patients know that if they are not ready for treatment, that we are still here to support them until they are. It’s asking the question, “what can we do to help you now?” It’s important to remember that not everyone’s recovery process is the same and we support any path our patients choose. Our goal for our patients is for them to achieve full and lasting recovery, however they may accomplish this.

How can a person enroll in the Gateway Rehab Center of Excellence?

It’s easy. A person simply has to pick up the phone, call 800-472-1177, ext. 1191, and express their interest. That’s it. We realize that sometimes picking up the phone and calling someone for help may be difficult, but, we’re here to help and assist those that may feel hopeless, helpless, and don’t know where else to turn.


Our next blog post will feature a Q&A with a Gateway Rehab COE patient.


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Therapists, counselors should recognize the signs and symptoms of substance use disorder

People trust their therapists or counselors with a variety of problems that arise in their lives. Typically, they share freely about these topics after establishing a supportive relationship with their therapist. However, a patient might also be struggling with a problem that they are less willing to talk about, which is their drug or alcohol use.

   It is important for counselors to be able to identify behaviors and symptoms that may point to the existence of a substance use disorder because these issues can be so damaging to a person’s life. Oftentimes, the problems that bring a person into therapy may be caused or worsened by their substance use and these issues cannot be fully resolved until the substance misuse is addressed.

   There are several reasons why a person may not be forthcoming about their drug or alcohol use. A person could simply be in denial or think they don’t have a problem. Sometimes a person will rationalize and compare themselves to others to justify their usage.  One might say, "well, I have a successful job and a loving family, so, I can't possibly have a drinking problem.” Or another may say, "I just use pills and I've never had an overdose, so, my usage isn't that bad.” 

   Another primary reason is that they fear the consequences of being honest about their usage. Consequences could include legal repercussions, the dissolution of their marriages or relationships, the removal of children from the home, or damage to their careers. In these cases, it is vital to review confidentiality laws with them to mitigate any fear that might be keeping them from being honest.

   Another reason that a person may conceal their drug and alcohol use is the stigma or “shame” of struggling with drug or alcohol use. Even though the medical community agrees that addiction is a disease and not a choice, a person going through addiction issues may still feel like they will face social judgment for getting help. One way to help a person work through this issue is to educate them about the disease concept of addiction and remind them that rehabs would not exist if people could address addiction problems on their own.

   So, what are some signs that therapists can look for in a person who may be struggling with substance use issues? Gateway Rehab uses a biopsychosocial assessment to identify impairments in functioning and to make substance use diagnoses. However, the most basic explanation is that substance use becomes a problem when it causes other problems in a person’s life. Other, subtler, indicators may include:

  • Changes in mood or persistent mood disturbance despite adherence to medication regimens
  • Loss of interest in activities or reliance on alcohol or drugs to be able to enjoy hobbies
  • Changes in performance at work or school
  • Cycles of illness that frequently include flu-like symptoms
  • Fear or anxiety when faced with the idea of “running out” of their drug of choice
  • Resistance to the suggestion of quitting the drug of choice

   Of course, this list is not all-inclusive and symptoms may be different for each type of substance. The reality is that substance use disorders fall along a spectrum of mild, moderate, and severe.  If a client meets only a few criteria for a substance use diagnosis, their usage is mild; their usage is moderate or severe if they meet additional criteria.  For example, a person who has multiple DUIs may have a mild substance use disorder.  On the other hand, a person who has a physical dependence on a substance, has lost jobs, is estranged from family, and/or has experienced overdoses, likely has a severe substance use disorder.

   Ultimately, what’s important is that counselors and therapists recognize the signs and symptoms of addiction so that they can assist their patients in getting the right type and/or level of treatment. If someone might have a substance use disorder, please encourage them to contact Gateway Rehab to schedule a complete drug and alcohol assessment.


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The role of medicine in early recovery

   Addiction is a chronic disease and, much like type I diabetes, hypertension and asthma, it is prone to relapse at staggering rates. In the past decade more than ever, addiction treatment centers and the field of medicine have been teaming up to develop the most effective ways to treat addiction and to prevent relapse. Following this trend, we have worked to incorporate medication-assisted treatment (MAT) into our well-established and evidence-based 12-step philosophy.

    In the midst of an opioid epidemic when many of our patients have been through numerous treatment centers, have tried 12-step recovery, residential treatment, and treatment programs offering only medication without success, we had to ask ourselves as treatment professionals, what can we do differently this time to improve the likelihood of our patients achieving long-lasting recovery.

    Our patients are unique individuals and are treated as such by an interdisciplinary team of professionals who understand their illness. Depending on the nature and course of each person’s disease, our team might suggest medication; however, medication is only a small piece of their suggested treatment plan. None of our patients are given medication unless as an adjunct to a holistic treatment plan that consists of therapy, group counseling, case management, and ongoing support. Medication is not and will never be a stand-alone treatment for the disease of addiction.

    We are aware there are varying opinions about MAT. Some believe a person is not “clean” when they are on medications, and others believe we are just trading one drug for another. One of our own therapists, named Joe, is a person in recovery himself and when he became a member of our MAT team he expressed some of these same thoughts and concerns. After five years working with us and seeing our process, Joe will tell you today that he understands our approach. He concedes that “the disease is getting worse and taking more lives than ever, and we have to use all the tools available to get people in treatment and help them stay there long enough to get better.”

    It is our belief that, regardless of medication type, a person will only get better if they engage in treatment and become active members in a 12-step program of recovery. Once a person develops enough positive support and has the skills needed to maintain long-term success and freedom in recovery, then they should no longer need the medication that only aided them to achieve that goal.

    While so much focus and debate can be placed on medications, it is our belief that the primary focus should be on the necessary changes a person must make in order to develop a healthy lifestyle of recovery. With or without medication, the same goal should hold true. Medication only serves to help those who need it to get through the toughest part of their recovery, the beginning, where so many people struggle.

    The path may need to be different for some, but the ultimate goal should be the same: to become free from active addiction and achieve health in body, mind and spirit.


Brandon D. Miller, LPCC-S, LICDC
MAT Program Specialist
Neil Kennedy Recovery Centers

Joseph P. Sitarik, D.O.
Medical Director
Neil Kennedy Recovery Centers

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