Don’t give up.

If John Mannion, RN, CARN has one bit of advice for anyone treating patients with an addiction, it is that, as a clinician, you never know when that one patient might turn the corner and reach out for help.


Such was the case with one of his patients, who had “tried everything” to stop drinking but only recently found the inner strength and the necessary combination of medications and therapy to stay sober. When John met Sara (not her real name), her self-esteem levels were at an all-time low due to a variety of factors. Over many years she had put her family through a great deal of pain and challenges. Now in her thirties, Sara knew she had to change.

“She told me her family ‘always loved me, but for a while they didn’t really like me,’” Mannion says. And then Sara went on to say she was going to a concert with one of her sisters, something she would not have done before she was in recovery.

Thankfully, Sara ended up at the Boston Medical Center’s Office-Based Addiction Treatment (BMC-OBAT), which provides a regimented and proactive method of treating individuals with substance use disorders. BMC requires individuals who are part of its program to undergo behavioral therapy in conjunction with medication to treat SUD, and also requires weekly check-ups for six weeks. After that, office visits transition to every two weeks, and then once a month.

A critical factor in addressing addiction is having support at the state level. Massachusetts has been at the forefront of addiction treatment in the United States. In 2007, the Massachusetts Department of Public Health, Bureau of Substance Abuse Services (MDPH, BSAS) created the State Technical Assistance Treatment Expansion (STATE) OBAT Program with the specific intent of integrating BMC’s Nurse Care Manager OBAT model into Community Health Centers.

Mannion, who became interested in treating addiction after a friend recommended he work at a local methadone clinic, has been at the BMC-OBAT since August 2017. He enjoys the work and recently became certified in addictions. While treating SUD can be challenging, he says, the positives far outweigh the negatives.
The key, he said, is understanding that not everyone who walks in the door is ready to make a life change. Patience is, perhaps, one of the greatest traits someone who treats patients with addictions can have. A patient might cancel appointments, time after time, but then, one day, he or she will be ready for treatment. “The person you think will never be ready for treatment will surprise you,” he says.

Sara was such a patient. But eventually, she reached a point where she wanted treatment. Sara is taking a once-monthly injection of naltrexone, an antagonist, as well as campral to help with cravings. In addition, as part of the BMC-OBAT program, she sees a therapist. Sara also attends Alcohol Anonymous meetings regularly as a support and has begun to participate in positive social activities, such as yoga.

Mannion firmly believes that the most important indicator of how well a person is fairing in recovery is not how long she or he has been sober, but rather how that person feels. Months, weeks, years in recovery are meaningless if the patient is still battling the same issues that caused the addiction in the first place. Recovery, he says, is different for everyone.
Learn more about BMC-OBAT here.