Be Well Texas tries to break down the silos of substance use disorder treatment

Be Well Texas is UT Health San Antonio’s substance use disorder program. It is funded by Texas Health and Human Services, and it supports patients around the state.

But officials at Be Well Texas argue their approach to addiction recovery goes beyond medication and 12-step programs. They said their holistic approach means more paths to recovery.

Dr. Tara Wright, the senior director of Be Well Texas, explained the philosophy behind their approach.

“We really try to look at it from a more holistic perspective, of what does this patient need?” Wright said. “That’s why there’s case management in our clinic to figure out what do they need — do they need food vouchers, is there legal assistance, is there housing insecurity issues that are occurring? What are the problems that individual is facing? Because all of that contributes to the substance use disorder.”

The virtual and in-person clinic services are free for low-income Texans, but Wright and others realized that paying for the services wasn’t the only barrier between patients and treatment. Another huge issue was transportation.

So, in late December, Be Well Texas finalized a deal with Lyft Healthcare to offer free rides for patients to get to the San Antonio clinic, and to labs and pharmacies around the state.

When a patient needs to make a clinic appointment or get to labs or a pharmacy, they will call their case manager at Be Well Texas and provide them with a pick up and drop off location. Then, support staff will arrange the ride and provide the patient with a window of time that works for them. All the patient has to do is get to the right location, get in the car, and they’re on their way to critical services.

Richard Hamner, Be Well Texas’ program manager of recovery support services, said when he was dealing with the worst of his substance use disorders, having free access to transportation would have been a lifeline.

“I still had a warrant out for my arrest, I had to take care of those issues, I didn’t have a driver’s license, didn’t have a vehicle, couldn’t get around,” Hamner said. “I also had legal challenges and other things that came with that — so I had appointments to make, I had to meet with parole officers, I had classes to attend, not to mention outpatient [care]. I needed mental health services at the time, with the bipolar and depressive disorders that I also had. Had I had Lyft, that would have made making those appointments quite a bit easier.”

He said that when he was dealing with all of these issues 15 years ago, he had to rely on public transportation. It was a critical tool but it wasn’t adequate for his needs. He added that it remains inadequate for the needs of many dealing with substance use disorders. So he had to make hard choices about what parts of his life to tend to and which parts to neglect.

“When I have to make all of these different appointments, I’m probably going to either no-show or not make some of those appointments. And then I just have to prioritize what’s most important. Generally, medication, making those appointments, were low on the priority list. They were most important for me physically, but not legally.”

Claudia Draper, a practice manager at Be Well Texas, said about 40 people around the state utilized the free Lyft Healthcare services to get to appointments, pharmacies, and labs.

She explained that the initial contract with Lyft Healthcare is a year-long, with the likelihood of renewal.

Be Well Texas is also starting to subsidize recovery housing for 18- to 25 year olds dealing with substance use disorders, finding ways to get people connected to internet services, and working with people in prison so that they can be on a path to recovery by the time they get out.

Wright said part of the reason for all of these services is that the need for substance use disorder treatment is so great in Texas — and it’s only increasing.

“Since the year prior to the pandemic [to] the year after, we saw almost a 79% increase in overdoses in the state,” she said. “So it is a huge need in our state alone, so in San Antonio it’s just the same.”

She said Be Well Texas has grown to try to accommodate that need, going from nine employees four years ago to more than 90. With that growth, and a new clinic which is in use but has not yet had its grand opening, Wright said they’re able to accomplish more.

“This space means the world to us because what it means is we’re able to come together and do things like problem solve for our patients and ensure that we’re collaborating with all of our experts and program managers like Richard [Hamner] to come up with creative solutions to barriers our patients hit,” she explained.

One of those creative solutions is Be Well Texas’ peer to peer support services, inspired by Hamner’s own experience as someone in long-term recovery from substance use disorders.

“I was what they called a 'serial relapser.' I was in and out of all kinds of treatment programs — residential, outpatient, you name it, and none of those were really successful,” he explained.

He said it required engaging with multiple different types of programs, including faith-based counseling, a men’s accountability group and a 12-step support group before he really saw results. That’s what made him realize that no one method to recovery will work for all people, and in fact, many people will need numerous different methods simultaneously in order to make progress.

“Whether it be mental health treatment, substance use treatment, whether it be some kind of job training, GED, whatever that is that we can help connect them for," he said, "we’re there, and we can do those things.”