Medication-Assisted Treatment For Opioid Use Disorder

January 5, 2021 – Article by Jim Harrington, MSU Extension, and Dr. Laurence Yung, DO, MBA, Chief Medical Officer of East Jordan Family Health Center

People can recover from opioid dependence or misuse with treatment, counseling and support.

Opioid use disorder (OUD) is a significant public health issue in almost all communities in Michigan. It affects many people, including individuals, families, emergency responders and those within the health care system. Opioid overdoses continue to be a preventable cause of death across all age ranges. OUD from prescription opioids often starts with treatment of a medical issue such as surgery, an accident, dental procedures, chronic pain, or an injury. In those who may be susceptible, opioid use may lead to dependence and/or misuse.

Please click here to read the article in its entirety:

To learn more about opioid use disorder and what you can do to support prevention, treatment, and recovery in your community, please visit MSU Extension’s MiSUPER website.

COVID-19 Policy Addendum 1

COVID-19 policy Addendum 1

Date: April 27, 2020


Harbor Hall is committed to mitigating the advancement of COVID-19 in any way that is within our control.  The CDC guidelines of social distancing and the Governor of Michigan Executive Orders has required Harbor Hall to take actions to isolate at risk, and our most vulnerable populations as best we can.  The purpose of this policy is to set forth standards of practice and strategies that will enable Harbor Hall to protect our residents, staff and the community as we begin to slowly reestablish operations.


There has been many changes that have occurred with the COVID-19 issues and the response to it on an almost daily basis.  Harbor Hall has developed and activated a COVID-19 Mitigation Response Plan.  We have complied with all of the orders of the State of Michigan in order to do our part to mitigate the problem.  We have worked in conjunction with the Northern Michigan Regional Entity, Mid-State Health Network, Northwest Michigan Public Health Department and the Recovery Centers of Michigan to address a variety issues.

The below policy is to establish procedures as Harbor Hall begins to reopen at a reduced rate as normal operations resume.

General Building Security:

  1. All exterior doors will remain locked at all times.
  2. Door bells will be installed to alert staff of visitors.
  3. Admin areas will have plexiglass barriers to protect staff
  4. Entrance log will be maintained, logging in and out of all visitors that will include temperature
  5. Ensure adequate supply of PPE is available for visitors and staff
  6. Ensure adequate supply Hand sanitizer is available for all visitors and staff.
  7. Ensure adequate supply of CDC COVID-19 questionnaires at the main entrance

Access to buildings:


  1. All exterior doors will remain locked at all times.
  2. Entrance to the facility will be through the main entrance only for visitors located on the south side of the building.
    • Staff may enter through the “Staff Only entrance” on the North side of the building.
    • All staff are to report to have temperatures taken at the beginning of shift.
  3. Anyone entering the building must have their face covered.
  4. Staff will have donned appropriate PPE to greet visitors.
  5. All visitors/guests entering the facility must answer the CDC guideline questions.
  6. Hand sanitizer is to be used by all visitors/guests prior to entering the building.
  7. Temperature will be taken of all visitors/guests prior to entering the building.
    • Temperature of visitors will be logged in the visitor sign-in/out log
  8. The general rule is: only one visitor/guest is to be in the administration area at a time, social distancing is to be maintained.
    • During admission of a new resident that may be extended to include one escort who will follow the same procedure for access above.
  9. Maintain the social distancing guidelines in all areas of the building.


All Outpatient sites including OBOT:


  1. All exterior doors will remain locked at all times.
  2. Entrance to the facility will be through the main entrance only.
    • All staff are to report to have temperatures taken at the beginning of the shift.
  3. Anyone entering the building must have their face covered.
    • Each client WILL provide their own face mask and staff will have a face mask made available to them if needed.
    • If a client does not have a face mask upon arrival at the building, they will be refused face-to-face services.
    • If refused face-to-face services, the clients will be asked to call for a teletherapy appointment with their counselor.

It’s important that the clients are aware of these requirements in advance.

  1. Staff will have donned appropriate PPE to greet visitors.
  2. All visitors/guests entering the facility must answer the CDC guideline questions.
  3. Hand sanitizer is to be used by all visitors/guests prior to entering the building.
  4. Temperature will be taken of all visitors/guests prior to entering the building. Temperature of visitors will be logged in the visitor sign-in/out log
  5. The general rule is: visitors/guest are to maintain 6’ in the administration area and in group rooms.
  6. Maintain the social distancing guidelines in all areas of the building.




Screening for appropriateness for services and placement at all sites and all services will be conducted over the phone or through Zoom as appropriate.

Admission/Intake Residential:

  1. Intake begins at screening, CDC approved questions asked in addition to the normal screen.
  2. Upon arrival, client and family will be screened again. This will now include Temp check for clients and family, sanitize, and isolate in front office until full check-in is complete.
  3. Once check-in is complete, client will be escorted to room which will be in 200 to 203. Those ten rooms will be sectioned off. The entire front area will be blocked from “cleared” client use. This area includes the music room, old stairs, and upper bathroom. Tape marking the floor in the upstairs and downstairs to denote limited areas.
  4. Isolated clients will be checked for symptoms twice daily.
  5. Isolated clients will wear a mask when outside of their room at all times.
  6. Isolated clients will collect their food at 12 and eat in their room
  7. Isolated clients will smoke either at separate times or off porch and away from other house members.
  8. Options for separate group schedule, otherwise clients will only attend Psychotherapy group and the one PM lecture.
  9. Isolated clients will remain in isolation for a minimum of 7 days or until cleared by the MD


Outpatient Services:

Drug Testing:

  1. Drug testing will commence as soon as possible once we are able to do so safely.
  2. Clients and staff will wear face masks during the drug testing procedure.
  3. Gloves may be worn by staff if deemed necessary.

Therapy/Counseling Sessions:

  1. When allowed to conduct face-to-face group therapy sessions, the group size may be limited depending on the Governor’s orders, social distancing practices and group room size.
    1. The group size is to be limited to 10 or less clients, clinical staff will break the large group number up into smaller sized groups to accommodate the Governor’s order at that time. This may require the facilitation of more group therapy sessions each week.
    2. OP Petoskey can also open up the upstairs main group rooms to one large room vice two smaller rooms. This will allow us to service more clients in a group setting while maintaining social distancing practices.
  2. For individual face-to-face therapy and assessment sessions, social distancing practices will be in effect along with the wearing of face masks for staff and clients alike.

OBOT/Primary Care:

  1. There is currently a back log of potential OBOT/Primary Care clients waiting for services.
    1. All of the precautions mentioned above will be in effect for the OBOT/Primary Care program.
    2. Continue with the standard screening process to see who qualifies and who does not qualify for the OBOT program.
    3. Clients will be brought in at an expected rate of 6 per day and will be intermingled with the current client caseload.
    4. Inductions will take place as scheduled but no later than 2 pm, Monday through Thursday.
    5. Existing clients will be seen up to 4 pm, Monday through Thursday.
    6. Clients will be scheduled on a first come-first served basis starting at 8:30 am and ending at 2 or 4 pm depending on whether the appointment is an induction or not.
    7. The schedule will be filled for all appointment slots for Monday before moving to Tuesday and so on. Appointments WILL NOT be scattered throughout the day/week but rather back-to-back each day.  We will do our best to accommodate a client’s desired appointment time and date but our schedule of the next available appointment time and date will prevail.
    8. Clients will be required to schedule their next appointment before they leave the OBOT office.
      1. Scheduling will be in the downstairs office to schedule those appointments.
      2. Appointments will be scheduled to include a 15 minute timeframe that is built into the appointment. In other words, if a client has a 2 pm appointment, they will be scheduled, and told to be at the appointment at 1:45 pm.
  • This extra 15 minutes will allow for check-in, drug testing, social distancing, etc. If a client is more than 15 minutes late for their scheduled appointment, they will be scheduled for the next available appointment which MAY NOT be that same day.


Telemedicine/Teletherapy will continue for those as appropriate and as directed by the State of Michigan or Northern Michigan Regional Entity.

Personal Protective Equipment

Hello to All,
Harbor Hall is desperately looking for protective masks and latex gloves for our personnel that are providing direct client/patient services. I know there is a severe shortage of these items, any assistance is greatly appreciated. Please reply to this post of Call 231-347-5511 for Holly or Peter or call 231-347-9880 for Lee.


Our response to the mitigation of the COVID-19 virus Harbor Hall residential is taking the following precautions:
1. All future admissions will be pre-screened for any evidence of the virus.
2. Limiting admissions from several counties.
3. No AA/NA community meetings on our residential campus for 2 weeks.
4. No visitations at our residential facility for 2 weeks.
5. Limiting access to our residential facility for 2 weeks.
6. Educate staff and residents on the signs and symptoms of COVID-19.
7. Educate staff and residents on preventive measures.

If you have a fever, respiratory symptoms, cough, contact your health care provider, by phone (not in person) to find out what the next step is.

I apologize for any inconvenience but we need to do our part to protect our residents, staff and community.

Petoskey-Harbor Springs Area Community Foundation Grant

Harbor Hall is very pleased to announce receipt of a grant through the Petoskey-Harbor Springs Area Community Foundation. The award is in the amount of $8,000.00 and is intended for sobriety and addiction support.  These dollars will help those individuals who are underfunded for addiction treatment services and also to provide gambling addiction treatment. Harbor Hall is a 501 (c) 3 non-profit that was established in 1974 as a substance abuse recovery facility and has been serving the community for 46 years.  Offices are located in Charlevoix, Cheboygan and Emmet Counties.


No Wrong Door

By: Pat McGinn, CEO Harbor Hall

Never did I think that I would take abstinence as the central goal for treatment out of our policies and procedures.  However, that has changed in the last couple of years with the height of the opioid epidemic hitting the nation, the state and right here at home.  I never dreamed that abstinence would be a term that stigmatizes people where the use of medications is necessary to achieve a certain quality of life.  There was a time in my professional career when I thought the use of any medication was compromising a person’s sobriety.  I found it necessary to evaluate my own ideas, prejudices and biases.  This was very hard for me to do.  Even right now as I write this I am finding it hard to put into words.

Here at Harbor Hall, we witnessed the opioid epidemic spiral out of control over the past decade.  The peak of the crisis was 2012-2016 where we saw for the first time opioid addiction account for nearly 60% of all our admissions in the residential program.  We began to recognize that we needed to do something different, but we were not exactly sure what.

In 2017, myself and our clinical team visited Hazelden Betty Ford Foundation and received specialized training in the Comprehensive Opioid Response with the Twelve Steps (COR-12). The COR-12 program is an evidence-based program that was developed by the Hazelden Betty Ford Foundation.  The approach includes the use of medications.  These medications for opioid use disorders are an adjunct—an addition—to other treatment programming, such as extended psychological and psychiatric care, counseling based on the Twelve Steps, and other therapies. Harbor Hall believes that the medications without any supporting program is not as effective as participating in a program that combines both.

Outpatient Based Opioid Treatment (OBOT): It took some time and preparation but this past year Harbor Hall started a treatment program that specifically addresses opiate addiction. Central to this treatment are medications, typically Suboxone (buprenorphine-naloxone) and Vivitrol (extended-release Naltrexone) are provided in combination with other medical and psychosocial interventions designed to realize a person’s highest achievable recovery.  Based on the assessed ASAM level and the needs of the person served, Harbor Hall provides a comprehensive array of treatment services that includes counseling (individual and group), medication supports, social supports, continuing care coordination and other recovery enhancing services designed to enrich an individual’s quality of life.

Harbor Hall Philosophy: A substance use disorder is a chronic medical condition that responds best when treated with evidence-based, patient-centered, comprehensive care.  Harbor Hall believes that a broad approach that integrates the latest addiction science with the spiritual foundation of the twelve step philosophy while providing medication-assisted treatment (MAT) will provide the best pathway to long-term recovery efforts from opioid use disorders.

marbles blog post image

The Marble

By: Pat McGinn, CEO Harbor Hall

When I was a child in elementary school, marbles were a valuable asset.  We would go to school with a big bag of marbles that was filled with a variety of sizes, shapes and color.  There were Cats eyes, steely, glass, clay, aggie, boulders, red devil mixed color, opaque, black, swirly, tiger, shooter and the most coveted of all (in my school) the puree.  As soon as the snow started to melt and spring was in the air, all of the kids would bring in marbles for games and we played for keeps.  Playing for keeps was very serious, so we had to choose wisely the type of marble to be used.  In those days purees were hard to come by,  so in our own made-up value system, the puree has the highest desire attached. 

As I grew older the excitement of the marble games diminished, and the bags were put away.  Maybe it is was just a kids game but I find it funny how you don’t see kids playing marbles anymore today.

About 25 years ago I met one of my most important mentors who was a great inspiration to me.  As a tradition he would give marbles to people who were completing addiction treatment.  He would say to me that the marble was an important symbol for persons new to recovery.  He had a presentation that was very special and unique in the presentation of this symbolic gift.  Over the years I had adapted this presentation that continues today. 

Over the past 25 years I venture to guess that I have given away hundreds of marbles.  These marbles are purees and crystal clear…the most coveted of all marbles (in my opinion).  So at each presentation I pass out a clear marble to each person they all look the same at first.  Then I talk about the symbolism of the marble as it relates to changing thinking.  (To understand grab a clear marble and look at it as I describe the meaning).

First notice that it is round.  The round is 360 degrees, reminding us that what goes around comes around.  It’s a completeness, it is the beginning and the end, the circle of life. 

Notice that it is clear.  This symbolizes that as we practice a routine of sobriety, our thinking clears up, we begin to learn how to live life in a rational manner and the choices we make become better. 

Notice that it looks perfect, but if you look closely you will see nicks, chips, scars, bubbles.  This reminds us no one is perfect and we all have our scars, chips, nicks, bubbles.  This is a reminder to be patient and tolerant of ourselves and of others.

Notice that when you look through it everything is upside down.  This reminds us that no matter the clarity of our thinking, the world around us sometimes feels upside down.

The group is told that this can be a powerful relapse prevention tool.  They are told that first they need to keep in in their pocket otherwise it will not work.  If you find yourself in a situation where you are on the verge of using, take the marble out of your pocket at place it on your forehead, then hit it with a hammer, if the marble breaks it is okay to use.  Okay that is meant to be funny, but I have had folks come to me and tell me that this is exactly what they thought of and in diverted attention.

Then finally, Keep the marble I your pocket and on those days when you feel like you have lost all of your marbles, you will have at least one.

From a game as a child to a powerful symbol of recovery.  I have had many people over the years come back and tell me that they still carry their marble as they pat their pants pocket. 

camp daggett alumni weekend

Harbor Hall Alumni Weekend Success!

Article by Ken Van Every, BA, Resident Life & Continuing Care Coordinator

The first Harbor Hall Alumni Reunion was held on September 1, 2018 and what a way to begin National Recovery Month but at Camp Daggett located on the shores of beautiful Walloon Lake and some amazing Harbor Hall Alumnus.

Many alumni with their families came out to re-connect and share their stories of recovery, their strengths, hopes and dreams. As Mike F. from Boyne City said “It was great to see everyone at Camp Daggett!! It was even better to see all the smiles and joy on all the faces!! Hopefully see more people next year. Thank you, Harbor Hall, for showing me that the grass can be greener!! Love you all!!” And Matt K. from Harrison “Such a blessed day. Sorely needed, words can’t explain how great it was seeing everyone!! Thank you, Heavenly Father!! #Grateful”, and Edward S. from Jackson “I just want to take a minute and say thank you to each and every one that made it out this weekend!!! Let’s keep this going guys it was amazing and enjoyed every second!!” And Joshua C. from Traverse City “It was so amazing to see everyone. It was a joy and brought tears to my eyes to spend time with everyone and all of Harbor Hall staff. Thank you, Harbor Hall, for giving me the gift of life and love again. Love every single one of you. Thank you again from the bottom of my heart. See you all next year.”

The day started with an open ceremony which first included members of The Little Traverse Bay Bands of Odawa Indians performing a cleansing with smoke ceremony and ceremonial drumming and singing. Dan Thompson Spiritual Director at the Hall delivering an invocation prayer, followed by Pat McGinn with opening remarks.

After the open remarks each alumnus came up to the stage to receive a Harbor Hall Alumni medallion, introduce themselves, where they were from and what they were grateful for. So, the opening ceremony was incredible and went as planned and I love it when a plan comes together.

The rest of the day was spent socializing, swimming, pontoon boat rides, games and dining on great food provided by Burnt Offerings from Petoskey.

In the evening a live Rockin Recovery concert was perform by Toby Jones from Harbor Springs. And finally, the evening ended with an open talk meeting around the campfire. A great time was had by all. Plans for next year’s reunion are already in the works.

A special thank you goes out to the Harbor Hall Foundation for providing support and Camp Daggett for providing the venue. Other contributors from the surrounding area were: Holiday Inn Express, Apple Tree Inn of Petoskey, Snippets of Time Photography, Reusch Jewelers, Sky’s the Limit Florist, Northern Michigan Artist Market, Grain Train, Charlevoix City Golf Course, Whippoorwill, Family Video, City Park Grill/Palette Bistro, Cutler’s, Great Lakes Gourmet, Grandpa Shorter’s Gifts, Morning Star Jewelry, Meyer ACE Hardware, Mighty Fine Pizza, Craig Ryan, David’s Place, County Emmet Celtic Shop, Roast and Toast, and McLean & Eakin Boksellers.