Medication Assisted Treatment with Sarah Joy Costello-Fedje

Stigma's Toll: A Podcast Series to Reduce the Stigma of Opioid Use Disorder Through Education

I was able to interview Sarah Joy Costello-Fedje for this episode. Sarah Joy has worked in the field of SUD since 2008. She has a Masters in Organizational Leadership, is a Licensed Alcohol and Drug counselor and approved supervisor thought the MN Board of behavioral health. She is a certified brain injury specialist, has DHS approved training in Fetal Alcohol Spectrum disorder and has worked throughout her career with expecting mothers on MAT. She is currently a director of a Medication Assisted Treatment program in the Twin Cities. During our interview, she discussed how MAT is a best practice, which includes both medications for Opioid Use Disorder, as well as therapy. This combination allows people to achieve a level of stability in their life, and reduce the harms associated with drug use. Some of these harms may include blood borne pathogens, abscesses, overdose and other injuries. She explained how every client has their own goal in terms of recovery, and MAT is there to help them achieve that goal. This may be simply using in safer ways, or reducing use, not necessarily full sobriety. For some, they may use these medications forever, as part of their recovery journey. She explained the two main medications used, Methadone and Suboxone, and why one may chose one over the other. She discussed the benefits of these programs are more than just the medications, but access to resources, mental health, annual physical health screenings, and possibly most importantly, connection. We discussed pregnancy and MAT, and how it’s safer for someone who is pregnant and has OUD, to be on MAT, to reduce the risk of withdrawal, which can hurt the fetus, as well as reduce the dangers of using street drugs while pregnant. Stigma was a large topic of the conversation, including in regard to OUD, MAT and the clinics themselves. Finally, we discussed a little about how COVID19 affected the access to these medications, and the criteria for taking home the medications to dose, versus coming to the clinic to dose daily.

References:

Vearrier, L. (2019). The value of harm reduction for injection drug use: A clinical and public health ethics analysis. Disease-a-Month, 65(5), 119–141. https://doi.org/10.1016/j.disamonth.2018.12.002

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