Philly’s recovery housing complex now offers residents on-site addiction treatment medications

Residents at the city's large recovery housing complex in Holmesburg are now able to receive outpatient addiction treatment services on site – including medication for opioid use disorder – instead of having to travel off campus.

Merakey and Gaudenzia, behavioral health providers that contract with the city, are operating the recovery housing services at the Riverview Wellness Village, at 7979 State Road. Merakey is now also licensed to provide methadone, buprenorphine and vivitrol – medications for opioid use disorder, or MOUD, that help ease withdrawal symptoms and cravings and reduce risk of overdose.

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MOUD, combined with therapy, is an evidence-based treatment and the gold standard of care for managing opioid use disorder and preventing relapse. Until recently, the approximately 50% of residents at Riverview on MOUD had to go elsewhere for treatments. Merakey and Gaudenzia were providing transportation to those appointments.

"The whole intention of this project, from the mayor's vision, is to have (services) all in one place," said Isabel McDevitt, the city's executive director for community wellness and recovery. "But given just the need to move quickly, we've had the layer in these services."

Being able to offer these medications and other outpatient addiction treatment on site, alongside existing primary care, case management, mental health services, "… is certainly a game changer" for residents, McDEvitt said, especially since methadone requires daily dosing.

A $100 million capital project, Riverview opened in January on a 20-acre city-owned site with a capacity of 336 beds. The city secured zoning approval in June to seek a developer to retrofit a larger building on the campus, for an approximate price tag of $75 million. Construction on that building, which will increase the complex's capacity to 640 beds, will start as soon as the city picks a developer, McDevitt said.

As of mid-September, Riverview had 186 residents. "The reason we're at 186 is not because of a lack of demand," McDevitt said.

The city is balancing the demand for recovery housing in Philadelphia with the ongoing development of Riverview. For instance, meals have been transported in as the commercial kitchen is being built. That facility, in the central meeting house, is in the final stages of construction, McDevitt said.

In addition to in-house providers Merakey and Gaudenzia, the Black Doctors Consortium offers primary care treatment and chronic disease management to people on site.

Riverview residents – who are allowed to live at the facility for up to one year – must be coming out of 30-, 60- or 90-day inpatient programs or from certain intensive outpatient programs. But even coming from inpatient treatment, most are still typically in the "early stages of their recovery," said Josh Vigderman, Merakey's senior executive director of substance use services.

Merakey offers residents individual and group counseling, case management and peer support, Vigderman said.

Offering MOUD on site "… allows for individuals to stabilize. It helps in terms of withdrawal management. It also takes away urges. And then when you combine that with the therapy, you're able to work on the challenges that individuals are experiencing that either brought them to their addiction, occurred during their addiction, and potentially keep them stuck in their addiction," Vigderman said.

Stigma associated with MOUD, especially in 12-step programs such as Alcoholic Anonymous and Narcotics Anonymous, is well documented.

"We view (MOUD) just like you would if you were a diabetic and you needed medicine to treat your diabetes," Vigderman said. "We don't look at it as you're substituting a legal drug for another drug."

In his 18 years working in methadone-maintenance programs, Vigderman said he has witnessed "countless success stories" of people who have been able to " … turn their life around, and that's really been because of the combination of medication and treatment and therapy."