Donald Parker is on the front lines of the war against opioids.
The CEO of Belle Mead-based Carrier Clinic is forming a behavioral health alliance with Hackensack Meridian Health and using 12-step therapy, cutting-edge technology and medical research to treat victims of the epidemic.
The largest behavioral health group in New Jersey, Carrier is negotiating the alliance with HMH in part to help fight the opioid epidemic. It’s also conducting a study with Texas-based Nexalin Technologies and the University of Pennsylvania to develop a specialized Transcutaneous Electrical Nerve Stimulators, or TENS, unit – a low-voltage device designed to ease patients through the painful withdrawal process.
Carrier also plans a host of other initiatives including:
“If you are suffering from addiction, we want you to come in and know that we’re going to have a solution for you,” Parker told NJBIZ. “If we aggregate enough ways of doing things, you’re going to have personalized medicine. You have to have a big war chest of ideas to help patients recover.”
In March, Carrier signed a letter of intent with HMH to partner on ways for each to enhance their behavioral health services. A partnership agreement is expected by month’s end.
“We hope the partnership will give us a lot more support for scientific studies and clinical trials,” said Parker. “It will help us make sure that patients in the Northern and Eastern New Jersey markets have more access to inpatient care when necessary through Carrier Clinic.
“The partnership will also help us be more efficient and effective because we’ll get Hackensack Meridian’s purchasing power – meaning they’re ability to assist us in a whole variety of ways when it comes to the insurance companies, so that will help us reduce costs in delivering care.”
Parker also noted psychiatry residents at the Hackensack Meridian School of Medicine at Seton Hall University and HMH’s psychiatric residency program will be able to log hours at Carrier Clinic.
“We will hopefully provide an opportunity for HMH’s residents to get some unique experiences here at Carrier Clinic. We have 280 patients per night here so I think we can give their residents good experiences,” he said. “"Our job is going to be to integrate our behavioral health services into different points of care delivery at Hackensack Meridian and to work with their behavioral health professionals. We have over 1,000 people working at Carrier Clinic so the idea is to be able to, hopefully, enhance their behavioral health care capabilities.”
Carrier’s facility has 40 beds for patients suffering from addiction, another 40 for patients suffering from both addiction and mental illness, and 15 for teenagers dealing with addiction. It also provides equine therapy, as it has two horses, two donkeys and a peacock on its campus.
“We are going to continue to expand,” Parker said. “One of the things that’s correlated to substance abuse is high-stress jobs. When you think about first responders – police, firemen, first-aid workers, EMTs, doctors, etc. Their jobs are particularly stressful. What we’re working on now is creating programs for those specific groups. We think those groups deserve a unique level of attention and care in as scientific way. We’re also going to be providing separate services for veterans.”
Parker said he hopes the upcoming study with Princeton University can help them find ways to intervene with patients before they relapse.
“We are looking a wearable device similar to Fitbit that will measure six different vital signs and measures them from the time you come into Carrier to the time we’ve stabilized you enough that you’re ready to leave,” he said. “So for instance, if you’re psychotic and you’ve become stabilized, your vitals will go down. But each individual has a unique pattern in how they go down.
“What we’re going to be doing is creating personal profiles for patients. When you start getting psychotic or start experiencing a craving, your vitals, temperature, etc., go up. We want to extract predictive value. So if we see someone has vitals that are markedly different than they were a week ago, we’ll contact them to see if they’re taking medication, whether they need therapy, whether they’re medication is working, etc., so we can intervene earlier to hopefully prevent a relapse or an episode.”
In its clinical trial with Nexalin and Penn, Parker is confident the TENS unit will be able to help stabilize addiction sufferers more quickly when used in combination with talk therapy and traditional detox medications, such as Suboxone and Ativan.
The TENS unit is meant to stimulate the hypothalamus, the part of the brain that controls body temperature, sleep, thirst and attachment behaviors. When abusing drugs such as opioids, the hypothalamus gets switched off.
“The hypothalamus loses functional capacity during substance abuse episodes,” Parker said. “When you are taking opioids, the hypothalamus functions are substituted by the drug. Right now, we’re in the process of documenting the short-term effects of the TENS unit, but we’re also looking at the longer-term effects. Hopefully, we’ll find that the TENS unit rehabs your hypothalamus back into full activity.”
All of this is done in conjunction with talk therapy, including 12-step programs.
“I analogize the 12 steps as physical therapy for the brain,” Parker said. “All of this technology will be done in conjunction with talk therapy. The 12 steps is a structured program that gets you to 90 Alcoholics Anonymous meetings in 90 days and gets you talking about addiction in a safe environment. Our goal is to use a whole variety of talking interactions, relaxation techniques [and] positive visualizations to help patients recover,” he said.
Parker said he is confident New Jersey slowly winning its war on addiction, and is especially encouraged that the federal government will be doing away with the IMD Medicaid Exclusion program Oct. 1. The IMD program excluded Medicaid from covering addiction treatment services to patients unless they are under 18 years old or over 65.
“On Oct. 1 that regulation will go away,” he said. “Right now there are few options for people with Medicaid, so I expect more Medicaid patients can get help after Oct. 1.”