About Assisted Recovery Centers of America (ARCA)
Providing Mental Health and Addiction Treatment in St. Louis, MO
ARCA offers the most comprehensive, science-based treatment program that is radically different from conventional programs. On the road to recovery, our program may well be the best option for you to attain and maintain long-term rehabilitation and make a better future for yourself and your family.
ARCA's Treatment Philosophy
Medically Assisted Treatment (MAT)
The opioid prescription problem exploded in the middle of the to late 90s and continued to get worse and worse in the early 2000s. As the pressure on doctors to slow down on the prescribing of prescription pain pills continued to grow the early signs of the heroin epidemic started showing up around 2005 and was directly linked to the indiscriminate and irresponsible use of opioid pain medications.
St. Louis and the Midwest at large were particularly vulnerable because Chicago was the distribution point for heroin smuggled in from Mexico. The heroin problem went undetected primarily due to the shrewd tactics deployed. Prescription opioid abuse was primarily within the White suburban community – age group 17 -30. Small-time dealers targeted the same young whites, mostly male to not only switch to the cheaper heroin but also become small-time dealers to sustain the habit. All this occurred under the radar of law enforcement.
Around 2007, Missouri drug courts and the Missouri Department of Behavioral Health became increasingly aware of the problem due to the rising incidents of overdoses and deaths. At this time Medication-Assisted Treatment (MAT) was restricted primarily to methadone treatment and was the only medication funded by the state.
In 2008, the state of Missouri looked at broadening the scope of MAT to include all medications approved by the FDA for the treatment of addictive disorders. These included Naltrexone, Vivitrol, Suboxone, Acamprosate, and Methadone. By early 2009, MAT was increasingly seen and promoted as a viable treatment option to improve treatment outcomes. The science behind MAT validated its use.
The success factors for MAT are medical detox (as opposed to social detox) and offering patients anti-craving medications that would prevent relapse along with treatment for psychiatric/dual diagnosis disorders.
The results of the program:
o Dramatic reduction in people leaving residential treatment against staff advice.
o Dramatic reduction in residential days – no more 28-days for everyone. Individualized treatment – the use of MAT gave many patients a chance for the first time to get well in their home and natural environment…Patients continued to receive MAT primarily buprenorphine and Vivitrol as they learn to live in a landscape dotted with cues and triggers associated with drug use.
o Dramatic reduction in overdoses and deaths.
o Greater interest and involvement from the patient with regards to counseling, family, job, vocational training, etc.
OVERCOMING THE CHALLENGES AND THE LONG-LASTING BENEFITS
The introduction and acceptance of MAT among the treatment community took time and effort. It took partnership, open-mindedness, and tremendous cooperation, and willingness to work as a team. MAT brought together clinics and programs that in the past operated rather independently, sometimes as rivals. The Department of Behavioral Health, in conjunction with the guidance from Percy Menzies, was the main driver and catalyst. Drug courts increasingly accepted MAT as part of treatment.
Prior to the introduction of MAT the addiction field had not seen much if any use of medications in treatment outside of Methadone. As a result, there was oftentimes little to no need for physicians or other medical providers. Finding physicians and getting them to obtain DEA waiver to use buprenorphine and training them on detox protocols proved to be a real challenge. Physicians and medical staff were turned off by the idea of treating those who struggled with addiction.
To further complicate the issue other members of the mental health community and the general community at large who now were being asked to be a part of the solution were set in the old way of doing things. Training social workers, counselors, therapists, probation and parole officers, drug court staff including judges on the benefits of MAT took time and a team effort. The results of the program spoke for themselves and clearly showed that integrated treatment is more effective than just self-help groups and social detox.
INTRODUCTION OF TELE-MEDICINE
Over the past 5 – 7 years, the Heroin Epidemic has exploded at a national level…in part due to the availability of the drug in the rural and underserved areas. Telemedicine was a natural offshoot of MAT, which now allows those in rural and underserved areas to receive the same level of medical and psychiatric care, essential for MAT.
Some of the Benefits of Tele-medicine are:
o Ability to serve those who would otherwise not have access to care
o Allows states to overcome the shortage of providers
o Forces all disciplines to work together which creates a holistic and comprehensive approach
Some of the Requirements for a successful Tele-Med Program are:
o Robust IT Infrastructure
o Knowledgeable and well trained medical staff (physicians and RN’s)
o Buy-in from the staff and community being served
o Strong and Open Communication – regular staffing of clients
o Multi-Disciplinary Team/Approach – must bring the medical and psychosocial components of treatment together through an acceptance of common and evidence-based modalities
WHAT ARCA CAN PROVIDE
1. Same-day access to a provider for both MAT and PSYCH services
2. Robust and Timely documentation of appointments
3. Knowledgeable and reliable Provider(s) that are able to prescribe Suboxone and other MAT Medications
4. Provider(s) that are knowledgeable about the treatment of addictive disorders and the medications used for these diagnoses
5. Provider(s) that are knowledgeable about the treatment of dual diagnosis and other co-occurring mental health disorders
6. The possibility of e-script services and calling in of medications along with peer support and nursing services.
Text 'ARCA' to 66-866
2021 ARCA opens a welcome center offering on-demand treatment, minimal wait times and a full interdisciplinary team.
2020 Scaled up online/telehealth inductions leading the region and sharing protocols. Deployed Licensed Social Worker, MD, and CPS to community settings. March-August 8,700 virtual visits were completed.
2020 Offices continued to stay open after the 1st confirmed COVID patient. Front line staff triage and assess clients needing MAT.
2020 Innovative Response to COVID-19 March, ARCA implemented contingency management and issues emergency protocols.
2019 ARCA becomes a training partner with SLU.
2018 ARCA provides direct admit via SOR. Rich collaboration developed with SLU by hiring Dr. Fred Rottnek.
2017 ARCA works with the Department of Mental Health to increase access to care via telehealth services.
2015 ARCA Initiates exploration of the national growth plan.
2014 ARCA integrates electronic medical records and billing program.
2014 ARCA opens a satellite outpatient clinic in Farmington, Missouri.
2013 Mr. Menzies opens two sober-living houses, Kaizan Properties, in St. Louis for males.
2012 Initiates process to open MIRA, the Menzies Institute of Recovery from Addiction, a 25-bed inpatient unit treatment center in St. Louis
2010 ARCA establishes a state-certified modified detox program for state-funded patients and received the highest certification from the State of Missouri (CSTAR).
2009 ARCA opens a second outpatient clinic in St. Louis in a 4500 sq. ft. space. Mr. Menzies consulted with Alkermes to launch the sustained-release preparation of naltrexone (Vivitrol).
2003 ARCA moves into a medical office building in a 2500 sq. ft. space. Continued to offer outpatient services and consulted with Mallinckrodt, Reckitt Benckiser, and ATTC. Expanded the clinics by taking on an additional 4000 sq. ft. space.
2001 Mr. Menzies opens ARCA, an outpatient treatment center in a 1200 sq. ft. office space.
2000 Mr. Menzies takes early retirement from DuPont Pharmaceuticals after 18 years of service.
During the late 1990s, Percy Menzies was product director for DuPont pharmaceuticals when naltrexone was approved by the FDA for the treatment of alcohol dependence. With an extensive background in pharmacology and niche product knowledge, Mr. Menzies believed this medication had the ability, if used in conjunction with behavioral therapy and other behavioral modification tools, to change the lives of those who struggle with addiction. Shortly after DuPont withdrew from the product in late 1999, Mr. Menzies took early retirement and dedicated his life to addiction medicine. In early 2001 he founded the Assisted Recovery Centers of America to bring the treatment of addictive disorders into mainstream medicine.