Opioid Addiction Recovery (SMART)

Medication Assisted Treatment Program at The Ohio State University

 SMART Overview

The Suboxone Maintenance and Recovery Treatment (SMART) program at The Ohio State University is a partnership between the Office of Student Life’s Counseling and Consultation Services (CCS), Collegiate Recovery Community (CRC) and Student Health Services (SHS). Our mission is to assist students with a history of opioid use disorder in maintaining their recovery by offering continued maintenance treatment with buprenorphine/naloxone, psychosocial support programs and recovery support.

As a collaborative team, we strive to support current and incoming students in recovery from an opioid use disorder that are utilizing medication assisted treatment and need medical providers who can continue to prescribe these medications as well as support their recovery and continued success both academically and personally.

SMART is designed for current or incoming students that have a year of successful recovery utilizing medication assisted treatment and are committed to maintaining their recovery while pursuing their education at Ohio State.

What We Offer

  • Continue providing medication at SHS
  • Individual and/or group counseling at CCS
  • On campus recovery support at CRC


  • Provide 12 months’ worth of prior medication assisted treatment records
  • Be committed to maintaining your recovery
  • Comply with all treatment protocols
  • Attend recovery support meeting (AA, NA, etc.) once a week
  • Attend weekly abstinence based group counseling at CCS OR weekly individual therapy counseling with a licensed professional
  • Attend CRC meeting once a week
  • Meet with prescriber at SHS once a month
  • Meeting and appointment attendance will be documented
  • Drug and alcohol screen once a month, at the discretion of the prescriber
  • Attend additional meetings with individual counselor, psychiatrist, etc., as determined by the prescriber

How To Apply

  • Contact the Care Manager at CCS by calling 614-292-5766

Katherine McKee, M.D.

Are you asleep yet?

The Wall Street Journal says that thermostat settings (the temperature in the room where you sleep) may be more important than light and bedtime to ensure a good rest.

Setting the thermostat to around 65 degrees Fahrenheit is good for sleep.  The body’s core temperature needs to drop by 2 to 3 degrees Fahrenheit to initiate sleep.  This prompts the brain to cool down.

During sleep, people’s bodies try to lost heat from hands and feet.  Put on socks if your feet are too cold.  If you are too hot, try sticking your hands and feet out from under the covers.

It’s best to wear light breathable clothing to bed, such as cotton.  layers of bedding that can be easily removed are ideal.

Pat Balassone, CNP

Suggestions for a Good Nights Sleep

To get a good nights sleep:

  1. Go to bed at the same time every day.
  2. Have coffee, tea, pop, and other foods with caffeine only in the morning.
  3. Avoid alcohol in the late afternoon, evening, and bedtime.
  4. Avoid smoking, especially in the evening.
  5. Keep your bedroom dark, cool, quiet, and free of reminders of school, work, or other things that cause you stress.
  6. Try to solve your problems before you go to bed.
  7. Exercise several days a week, but not right before bed.
  8. Avoid looking at phones or reading devices that give off light before bed.  This can make it harder to fall asleep.

Because of the limited benefits and substantial risks of sleeping pills, Consumer Reports advises that sleep drugs should be used with great caution.  The American Academy of Sleep Medicine no longer recommends sleeping drugs as a first-choice treatment for chronic insomnia, opting instead for cognitive behavioral treatment (CBT).

Patricia Balassone, CNP

Veggie Vitals: Kale, the New Spinach?

A couple of summers ago I joined a food co-op.  It was located right here on campus and once a week I received a bag of organic fruits and vegetables.  I never knew what would be included and even when I saw the items sometimes I still didn’t know what they were.  That was how I was introduced to Kale.  It appeared one day in the bag.  I had always thought kale was seaweed. Nope.  That would be kelp.  Googling the veggie I found that it is considered to be a wild cabbage and is touted to be one of the top healthy foods.

Great – but I still didn’t know what to do with it.  Back I headed to Google to find some recipes for this quite hardy looking green.  Turns out there were quite a few.  I gave kale chips a try – not really a fan.  But I did find a recipe for kale quinoa salad which quickly became a favorite request of my mom for family gatherings.

Here is the quite impressive list of nutrient you can receive from a single cup of raw kale, containing 33 calories, 6 grams of carbs, and 3 grams of protein:

  • Vitamin A – 206% of the RDA
  • Vitamin K – 684% of the RDA
  • Vitamin C – 134% of the RDA
  • Vitamin B6 – 9% of the RDA
  • Manganese – 26% of the RDA
  • Calcium – 9% of the RDA
  • Copper – 10% of the RDA
  • Potassium – 9% of the RDA
  • Magnesium – 6% of the RDA
  • 3% or more of the RDA for Vitamin B1, B2, and B3, iron and phosphorus

And here is the recipe for kale quinoa salad:

  • 10 kale leaves, washed and torn into bite size pieces
  • 1-2 cups of cooked quinoa (I find that 1 cup is plenty, but the original recipe called for 2 cups)
  • 1 cup pecan or walnut halves
  • 1 cup feta cheese
  • 1 cup pomegranate seeds, currants, or craisins
  • 3 tbsp olive oil
  • 2 tbsp lemon juice
  • 1 tbsp dijon mustard
  • 1 glove minced garlic
  • Salt/pepper to taste

Whisk together the olive oil, lemon juice, mustard, garlic, salt and pepper. Pour this dressing over the kale leaves, being sure to give them a good coating.  Add the remaining ingredients.  (Make sure the quinoa is cooled.)  Enjoy.

Veggie Vitals: Eggplant Eccentricities

eggplantTo be honest, I’m not quite sure what to do with an eggplant.  It has such a pretty color and shape and is used in dishes such as ratatouille and eggplant parmesan, but whenever I try to incorporate this vegetable into a dish it just doesn’t work.  The eggplant itself always ends up kind of squishy and well, just not very appealing.

It does have quite a few health benefits, though, so it’s well worth your while to figure out how to cook this purple beauty.

Heart health – animal studies show that eggplant may help lower overall cholesterol and improve blood flow.

Brain health – contains nasunin which may help promote healthy brain function by protecting brain fats through scavenging free radicals that target brain lipids.

Digestion and Weight Loss – 1 cup of eggplant contains about 8% of the daily recommended dietary fiber and that 1 cup, cubed and cooked, contains only 35 calories.

Bone health – Contains many of the minerals needed to maintain strong, healthy bones; manganese, potassium, magnesium, and copper.

Cancer prevention – The phytochemical known as BEC5 is believed to kill cancer cells without harming healthy cells.  BEC5 cream is purported to have worked in thousands of cases with a success rate of nearly 100% when used for 12 weeks. (The FDA has not yet approved its use in the US.)

Seeing all of these health benefits has inspired me to once again give the eggplant a try.  Perhaps this recipe from Rachael Ray will do the trick:

Sesame-Honey Eggplant

Brush 1/4-inch-thick eggplant planks with vegetable oil and broil, turning once, until tender. Drizzle with a dressing made with equal parts soy sauce, honey, toasted sesame oil and rice vinegar seasoned with freshly grated ginger. Top with toasted sesame seeds.

How about you?  Have you been ab

Doc gives straight “poop” on floating feces

Turner---floating-fecesFloat or sink?  Not really a question I’ve pondered with friends, but apparently it was a point of discussion for some students in the 70s.  Youcan check out the original article written by Dr. Spencer Turner in the Lantern Archives. Interestingly, as I was reading through this column, it did remind me of a presentation I sat through back in the late 80s.  A guest speaker came to a division luncheon and spoke on – yes floaters versus sinkers.  Not really the lunch time conversation I was expecting, but entertaining none the less.  The basic premise of his presentation was that you could measure your health by whether you had 6 inch sinkers or 8 inch floaters.

I would have expected the 8 inch floater to be an indication of health – thinking that the more water and veggies you were eating the less dense the result, but that is not the case.  It’s the 6 inch sinker that’s an indicator of health.

Floaters can be caused by a number of reasons, but the most common are:

  • Poor digestion – the body has to work harder at breaking down food which creates more gas and as a result gas-filled stools.
  • Gastrointestinal infections – cause the digestive system to flush out harmful bacteria and viruses, making food move through the colon too quickly and as a result gas-filled stools
  • Change of diet – eating more veggies and the like is tougher for the body to break down and as a result gas-filled stools

Hmm – did you see a theme?

Just in the case the floater versus sinker conversation doesn’t provide enough fodder, here’s some more tidbits from WebMd:

  • Healthy stool comes in all shapes and sizes, curvy, sausage, snake-like, and more. You need to seek out a doc if it looks thin and narrow like a pencil for several weeks.
  • Healthy stools come in a variety of colors, yellow, tan, green and more. Usually the change in color is a result of medication or food.
  • Tarry, sticky, black poop can be sign of bleeding or injury in the stomach or parts of the intestine. Always get this checked out by a doctor.
  • It’s OK if you don’t poop every day. Your body knows what it’s doing.  If, however, you have 3 or less BMS in a week, then you may be experiencing constipation.

Tina Comston, M.Ed.

Why Flu is a Bigger Threat to US population Than Ebola

Since December 2013, the fear of the potential effects of this disease in the U.S. has grown significantly. Fear heightened when the first patient was diagnosed in our country on September 30th. While Ebola is a major international health concern, it does not represent even a fraction of the degree of risk that influenza does for us every year. In order to understand why, a closer look at how each disease spreads and some statistics are warranted.

  • Ebola is a disease that requires direct contact with body fluids from someone who is infected with the virus or with objects contaminated with these fluids for person to person disease transmission. In contrast, flu can spread by respiratory droplets from infected individuals that can travel through the air up to six feet to potentially infect others. Additionally, the flu virus can live on surfaces outside the body for up to 48 hours and others can become infected when they touch these surfaces and then touch the eyes, nose, or throat without washing their hands first.
  • Ebola is only contagious when infected people start displaying symptoms. Flu, on the other hand, can be spread to others a full 1-2 days before a person becomes ill from it.

In West Africa, there are key factors that have facilitated the transmission of Ebola:

  • In this region of the world, the movement of human populations is approximately 7 times higher than the migration rates for other regions of the world (Alexander et al., 2014).
  • Bushmeat is a primary dietary staple in many regions of West Africa, representing as much as ¾ of an area’s meat source. The consumption of bushmeat represents a primary way for humans to become infected with Ebola from infected animals.
  • In this region, fear and mistrust of modern healthcare practices among a significant portion of the population remains, which can be very problematic for healthcare workers. In addition, these regions lack modern medical facilities and necessary medical supplies to offer humanitarian aid.
  • One of the most significant findings that has helped foster the rapid spread of Ebola in these regions are the traditional burial practices that are utilized for the dead. When a loved one dies, it is customary in many of these regions for family members and friends to help wash and prepare the body for burial and they also may spend a long period of time with the deceased person’s body. With proper protective equipment lacking and the massive loss of body fluids that are typically lost when someone with Ebola dies, this factor represents a significant potential mode of disease transmission. In Guinea alone, it has been estimated that 60% of the Ebola cases seen have been linked to traditional burial practices, including one funeral alone that was linked to the spread of the Ebola virus and subsequent deaths of 365 other people (World Health Organization, 2014).
  • The experience in the United States with the spread of the Ebola virus has been vastly different than the experiences in West Africa and can best be illustrated by looking at the cases of the first patient diagnosed with Ebola in the U.S. and the subsequent transmission to two nurses who cared for him. Both nurses who cared for the first patient did so at a time before there were clearly defined procedures for taking off equipment that healthcare workers use to help protect themselves from exposure, so it is thought that their exposures may have come from exposures to body fluid that may have occurred as part of the removal process. Furthermore, out of the 177 contacts of all three of these individuals with Ebola in Dallas (Chevalier et al., 2014) and the 164 Ohio contacts of the second nurse who traveled to this state (McCarty et al., 2014), not one person developed Ebola, even the persons living in the same household as the infected individual. While Ebola remains a significant concern today, the U.S. experience with the successful containment of the virus has been reassuring.

Unfortunately, the facts and statistics are not nearly as reassuring for influenza as can be seen from the following:

  • Each year up to 20% of people living in the U.S. becomes ill from the flu (Centers for Disease Control and Prevention, 2014a).
  •  Approximately 200,000 people each year are hospitalized with flu cases and flu deaths have ranged from approximately 3,000 people all the way up to 49,000.
  •  In 2013, nearly 60% of the cases of flu in people that had to be hospitalized occurred in people ages 18 to 64 years old (Centers for Disease Control, 2014b).
  •  Flu related deaths have been seen in college students, such as the previously healthy 22 year old Wright State University student who died in 2013  (Ohio College, 2014) and the 29 year old mother of three in Texas who died earlier this year (James, 2014).
  • College students are naturally very susceptible to getting sick from influenza in large part due to their hectic lifestyle and the exposures that they have to large numbers of others as a result of attending classes, social gatherings, and living arrangements

Fortunately, there is influenza vaccination available that can help protect college students and others against the flu and is widely regarded as the most effective way that individuals can protect themselves from becoming ill with the flu. Even in the years when it is not a perfect match for all of the strains that are circulating, such as what is occurring so far this year, it is still a good idea to get when this happens for three reasons:

  • There are usually three or more influenza strains that circulate in any given year, so it will very likely be a good match for two of the three strains and will offer protection.
  • There is also some evidence that suggests that previous exposure to flu strains in the past can offer up some protection if the same strain is encountered by the individual in the future


  • Even when someone who has been vaccinated against the flu becomes ill from it during the same flu season, the severity of the illness tends to be milder than the cases seen in people who become ill who did not receive the flu vaccine during the season.

Another important fact to note is that many people do not realize that it takes two weeks for his/ her full immunity to build up after being vaccinated so he/ she may think that they got the flu from getting the vaccine when in actuality, they may have been exposed during to the virus during this two week period or to another disease that mimics flu symptoms.

In addition to getting the flu shot, there are other measures that people can take to help limit the spread of influenza, such as:

  • Make sure that hands are clean before touching the eyes, nose, or throat
  • Stay home when you are sick until you have been fever free for 24 hours without the use of ibuprofen, Tylenol, or other fever reducing substances.
  • Avoid close contact (within 6 feet) with others who appear to be ill.
  • Get in the habit of sneezing and coughing into your elbow, or cover them with a tissue
  • Wash your hands with soap and water or alcohol gel or foam at key opportunities, including after touching objects and surfaces that are commonly touched by many others, such as elevator buttons, doorknobs, and stair banisters.


Alexander, K. et al., (2014). What factors might have led to the emergence of Ebola in West Africa? Retrieved from http://blogs.plos.org/speakingofmedicine/files/2014/11/Alexanderetal.pdf

Centers for Disease Control and Prevention (2014a). Seasonal influenza questions &answers. Retrieved from http://www.cdc.gov/flu/about/qa/disease.htm

Centers for Disease Control and Prevention (2014b), Flu activity during the 2013-2014 season. Retrieved from http://www.cdc.gov/flu/pastseasons/1314season.htm

Chevalier, M.S. et al., (2014). Ebola virus disease cluster in the United States- Dallas County, Texas, 2014. MMWR, 63(46), 1087-1088.

James, S. (2014). Healthy Texas mom dies of flu, 29, leaves 3 kids. Retrieved from http://abcnews.go.com/Health/healthy-texas-mom-dies-flu-29/story?id=21467701

McCarty, C.L. et al (2014). Response to importation of a case of Ebola virus disease- Ohio, October, 2014. MMWR, 63(46), 1089-1091.

Ohio college student dies from flu complications (2014), Retrieved from http://www.wlwt.com/health/Ohio-college-student-dies-from-flu-complications/18088622

World Health Organization (2014). Sierra Leone: a traditional healer and a funeral. Retrieved from www.who.int

Death with Dignity

Death with Dignity.  What exactly is that?  Is it fighting for life with all you have?  Is it facing the reality of a terminal illness and choosing to control the illness as opposed to the illness controlling you?  Is the dignity component directed towards the person facing death or towards their loved ones? Or perhaps it’s something else altogether.  I don’t know that death with dignity can truly be defined until we ourselves are faced with such a situation.  It is only then, at that moment, that we will know how dignity is defined for us.

Brittany Maynard, is at that moment.  She has been diagnosed with a rapidly growing brain tumor and has been told that she will face a debilitating, painful, and certain death. She has been thinking of life and of death and defining for herself dignity.

“I can’t even tell you the amount of relief it provides me to know that I don’t have to die the way that’s been described to me that my brain tumor would take me,” Maynard said. “I will die upstairs in my bedroom that I share with my husband, with my mother and husband by my side… and pass peacefully,”

Brittany has moved to Oregon and under the Death with Dignity Act and has obtained a lethal dose of painkillers which she will use to end her life on November 1, 2014.  This is dignity for Brittany Maynard.

Submitted by Tina Comston, M.Ed.