Dr. Connolly greatly enjoys her work in family medicine because of its focus on the idea of whole-person healthcare, which emphasizes not thinking about patients as organ systems but as a whole human being. Initially, treating opioid use disorder (OUD) was never part of her plan when went into medicine but over her first few years as a physician she met many patients struggling with substance use disorder (SUD). This opened her eyes to how common substance abuse is and the significant overlap between SUD and mental health. Previously, there were no good treatments for opioid addiction but now, with the development of suboxone, successful treatment plans can be created for patients. About 5 years ago she developed networks with different prescribers in the community to have places to refer patients who came in with SUD. At the time, Dr. Connolly didn't have her waiver but she was still supportive of treating patients with substance abuse issues.
Eventually, one of the patients she had known the longest changed her mind. This patient struggled with heroin addiction and did not disclose this, although over the course of a few years through visiting Dr. Connolly they became friends and the patient eventually opened up to her about their heroin addiction. Dr. Connolly let them know that this was okay, and began to find a doctor to help provide treatment. However, the patient didn’t want to go to another doctor, they wanted to be treated by Dr. Connolly, someone they trusted. The patient asked Dr. Connolly to get her x-waiver license so she can be the one to treat her. Thanks to the patient’s persistence, Dr. Connolly signed up for the course and applied for an x-waiver. A couple months later, she received it and did her first induction (getting patients started on suboxone) on this patient. This patient visits Dr. Connolly regularly and since then has obtained sobriety, gotten off probation, and is no longer homeless. Dr. Connolly expressed her joy in watching her patients grow as a human being and seeing how much potential they are capable of. This patient significantly changed Dr. Connolly as well, calling on her to do something that she previously did not consider as a part of her job. This is one of the things that Dr. Connolly enjoys in medicine - many of her patients have challenged her in a good way, and encouraged her to take a step forward in her personal development.
Accomplishments, Future Plans, and Shoutouts
Currently Dr. Connolly has minimal patients on suboxone, as she is the only one in her practice who can prescribe it. However, after the pandemic she hopes to recommit to her work with the SUD population. In addition, the California Society of Family Physicians (CAFP) is doing work to provide comprehensive suboxone and SUD treatment to patients all over California. Part of her work involves trying to overcome bureaucratic barriers, such as the x-waiver license.
Dr. Connolly believes that the x-waiver is currently the biggest barrier for treatment of OUD patients. She highlights an inconsistency with training - she can prescribe more dangerous things than suboxone without having to obtain a license. Additionally, patient induction has some controversy on whether physicians should be present for the first time. She mentioned that it can be hard to shoehorn a patient in for 3-4 hours just to complete an induction. There is also significant stigma associated with people who have SUD. Many clinics don't want to treat “drug addicts” which is an extremely harmful attitude to have. Patients themselves must also be motivated. Many people with “invisible SUD'' come in with headaches but do not mention heroin use or drug use. Without asking, they will not mention it. Dr. Connolly notes that it is important to ask the same questions over and over again and usually after the 3rd or 4th time you ask they tell. Dr. Connolly believes that the best way to overcome these barriers is being persistent and providing a safe environment for treatment where patients will not be discriminated against.
With the CAFP, Dr. Connolly and other physicians complete office based opioid treatment. They do many educational sessions, have a number of physicians who are subject matter experts, give lectures, and attend conferences to provide trainings. Their objectives include evaluation, treatment, and long term management of patients with OUD. They push out information to their 10,000 members, raising significant awareness as well.
For Dr. Connolly, the pandemic turned attention away from everything except taking care of COVID patients. Healthcare facilities were overwhelmed, and forced providers to have to change the way we deliver healthcare. They developed alternatives such as tele-health and drive-through medicine pickups. Physicians had no option but to fully respond to the pandemic and de-prioritize other activities. The early pandemic had a lot of confusion, with physicians wondering if it was okay to prescribe suboxone over telehealth. Now, many patients have been lost as they haven’t come into clinics for a couple years. They have begun a lot of outreach but some patients have been unreachable. The pandemic worsened the opioid epidemic as well, but how badly is still unknown.
Dr. Connolly believes that her best teachers have been patients themselves, as she learns a little bit from every single patient you see. Over time, patients have shaped her into the physician she is today and she is deeply grateful to every patient. To Dr. Connolly, there is no greater honor than being a physician or being a part of any healthcare team. She finds it very necessary and rewarding, but notes that the key is to have a passion for healthcare and a general love of people.
For this Month’s Opioid Epidemic Hero of the Month we would like to introduce Dr. Shannon Connolly! Dr. Connolly is a family medicine doctor, currently serving as the Associate Medical Director at Planned Parenthood. Here, she manages primary care services at 7 clinics located in both the Orange and San Bernardino Counties. She spends approximately half of her time as a family medicine physician, and the other half leading programs in the county. She oversees a behavioral health program and is also the President of the California Academy of Family Physicians.
Dr. Connolly was born in South Africa, and moved to the United States when she was 3 years old. She lived on the east coast until she graduated high school, and afterwards attended Brown University located in Rhode Island. Dr. Connolly eventually moved to California to attend the University of Southern California’s School of Medicine, completing her residency at the University of California, Los Angeles in Family Medicine. After residency, her first job was at Planned Parenthood, where she has been employed ever since.
Opioid Hero of the Month: November 2021
Dr. Shannon Connolly
Is there an Opioid Epidemic Hero in your community in Orange County? If so, let us know at firstname.lastname@example.org! We would love to include them in our series.