Small Town Brings In Big-Thinking Addiction Specialist And Changes Everything

By Maggie Ethridge 12/12/18

Nearly 82% of rural Americans live in counties that do not have detoxification services and the town of Ashland, Wisconsin sought to change that reality.

small town where an addiction specialist instituted a new addiction treatment program

In a little town in Wisconsin, where the death rate from drug and alcohol abuse is almost twice as high as the state average, Dr. Mark Lim has changed the lives of those addicted and their families.

A certified addiction specialist since 2016 (when it became a subspecialty of certification), Dr. Lim arrived in the town of Ashland as the newly hired recovery program medical director at NorthLakes Community Clinic.

Rural communities typically lack basic resources to treat substance abuse.

Nearly 82% of rural Americans live in counties that do not have detoxification services, a staggering number. This means anyone struggling with drug addiction has two choices – they can try to endure detox on their own (often medically unsafe), with the support of a local doctor (often hard to find in such areas) or they can relocate to begin treatment.

A recent poll by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health named opioid and other drug abuse as the top health concern for rural Americans.

The town of Ashland wanted to change this scenario. To fund an addiction treatment service program, NorthLakes applied for and won a grant from the state of Wisconsin, in addition to obtaining other federal grants intended for mental health and addiction.

The next step was to hire a doctor to prescribe buprenorphine, known by the trade name Suboxone. Only doctors with special training are legally allowed to dole out Suboxone. Another staggering statistic on rural reality: a 2015 study found that more than 80% of US rural counties do not have even one physician able to prescribe it.

Dr. Lim was hired and flew into Ashland with one request: He wanted to head a comprehensive program to treat addiction and not just treat it from one angle. Dr. Lim told NPR, "Opioids are big right now, but you have to work with alcohol too. You have to work with marijuana too. You have to work with methamphetamine, cocaine."

The addiction recovery program was built with community partners including educators, law enforcement and tribal leadership. The Ashland program includes a combination of counseling, group therapy for addiction and underlying mental health issues, as well as case management. Staff help patients with things like transportation to the clinic, daycare during therapy sessions and employment.

John Gale of the Maine Rural Health Research Center supports this program structure, telling NPR, “That's exactly the way it should be done. Because most people with a substance use disorder have co-occurring mental health and substance use problems. If we take care of [a patient's] heroin problems and we don't treat the underlying mental health and substance abuse problems, they're going to go to go to [sic] alcohol, they're going to do something else."

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Maggie May Ethridge is the author of Atmospheric Disturbances: Scenes From a Marriage (Shebooks, 2014) and the recently completed novel, Agitate My Heart. She is a freelance writer published in Rolling Stone, VOX, Washington Post, The Guardian and many others. Find her at her blog Flux Capacitor or on LinkedIn or Twitter.