Be Well Clinic offers recovery, hope

It was a milestone moment for Corpus Christi native Alexandrea Villa - a small but powerful step in her journey. She bought sheets for her new bedroom set.

"I look at my apartment and wonder if I want to buy something because I won't be there forever. And then I realize, 'Shoot, look at that. I'm planning for the future,'" she said. "I keep having those moments the more I keep being positive. It's cool."

Since she was 17, Villa misused various substances, including cocaine, marijuana and alcohol. Extra money for purchasing new furniture and gifts for her nieces and nephews was instead used to buy drugs. And her outlook on life was far from positive.

"I would wake up, go to work and drink. That's all I would put into my day. And now that I'm not drinking or using drugs, I have time to put into different things I want to do," the 30-year-old said.

After the death of her father from a drug overdose over a year ago, Villa began using drugs more heavily. With the support of her family, she moved to San Antonio and entered a local rehabilitation center. As the end of her rehabilitation loomed, a counselor introduced her to Be Well Clinic, a state-supported initiative within the Be Well Institute on Substance Use and Related Disorders at UT Health San Antonio.

Widespread need for treatment

Launched in October 2021, the Be Well Clinic offers in-person and telehealth substance use treatment and recovery services for anyone in the state, regardless of their ability to pay. Since opening, the clinic has served over 2,580 clients. Last year, the program celebrated the grand opening of a 20,000-square-foot facility that brings together medicine specialists, behavioral health experts, researchers and recovery coaches under one roof.

"Thirty years ago, clinicians would say we need to stop the substance use before you can evaluate any other psychiatric problems such as depression or anxiety," said Van L. King, MD, DFAPA, FASAM, medical director for the clinic. "But now we take the approach that we need to treat both problems at once. They significantly affect one another. It's not unusual that people with substance use problems also have other mental health problems. It makes tackling one more difficult if you don't tackle the other."

King said anyone needing the clinic's services will find that they will be treated with respect and have an appointment within a week. Additionally, the clinic offers free transportation through a rideshare program, a mail-order pharmacy and 24/7 live peer support to help patients access services when and where they need it. At the clinic, patients are evaluated by a psychotherapist and a physician or nurse practitioner who are experts in substance use disorder treatment.

Patients are then offered a choice of services, including a case manager, should they need help obtaining a state identification card, sober housing, or any number of social services. Patients can also arrange to meet with a peer coach through the clinic.

"Many people find they are sort of lost as to the first step. A therapist can help with that, but sometimes people feel more comfortable with people who can understand them from a more personal point of view," King said.

Importance of peer support

Peer or recovery coaches who themselves have misused drugs and are now in recovery can relate to patients through their shared experience. King said the vast network of coaches through partnerships with other agencies is especially helpful in rural communities.

"For some people, misusing substances is their major social connection. If you are going to stop, you have a lot of time on your hands. You have to figure out what you are going to do for socializing and recreation," said King. Peer recovery coaches can help fill the gap and offer alternatives for socializing to maintain the patient's sobriety.

Within the peer recovery community, patients will find acceptance of the use of medications to maintain their recovery, said King, noting that patients using methadone maintenance treatment or other medications to help with their sobriety sometimes have a difficult time receiving support in the community.

"There is a stigma of being on an opioid to treat opioid use disorder, and some believe you should just be abstinent from all substances," he said. However, it is clear from decades of research, that medication plus counseling is the most effective way to treat severe and chronic substance use disorders, King said.

"The peer recovery coaches are educated and accepting of medications. That's going to have a significant impact on general attitudes toward medications to treat substance use problems as time goes on." And yet, stigmas are still prevalent outside the recovery community.

"It's clear that half of the risk for substance use problems is genetics - what you've inherited," he said. "There are a lot of differences in people that folks tend to overlook when they are judging others."

Expanded access through telemedicine

The use of telemedicine, King said, has been a game changer for the treatment of substance use disorder. With 191 of the 254 counties in Texas considered rural, telemedicine was necessary to expand the reach of the services provided.

"It may be one of the only positive things that came out of the COVID-19 pandemic is this rapid transition to making medical services, including mental health and substance use services, available more readily," King said. "Not every patient likes to use telemedicine all the time, but it certainly is better to have it available remotely than not have anything available."

Since inception, the clinic has served over 2,400 clients through telemedicine. King said the future of Be Well Clinic is to broaden services across the state and continue its evidence-based treatment.

"We have research projects that people can participate in to access new approaches to treatment. We have highly experienced clinicians who are academically affiliated and up on the most recent cutting-edge treatments available," he said.

As for Villa, she sees her future very differently now. She is looking forward to maintaining her sobriety, spending time with her family, and continuing to learn more about herself.

"So far, the biggest thing I've learned about myself is that I am worthy," she said.

Be Well Clinic is funded by the Texas Health and Human Services Commission through federal funding from the United States Department of Health and Human Services and the Substance Abuse and Mental Health Services Administration. To learn more, visit bewelltexasclinic.org.

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