Although stigma and misunderstanding still exists, addiction treatment has progressed into a high-priority field of healthcare requiring specialized experts. Physician Assistant Laura Maroldo is one of those experts.
Medly Pharmacy is committed to making prescription medications accessible for all by providing greater convenience, value and approvals. Our newest Medly practitioner profile highlights Laura Maroldo, Chief Physician Assistant at West Midtown Medical Group in New York City
As an addiction medicine practice, West Midtown sees patients being prescribed addiction treatments, such as Methadone, Suboxone or Vivitrol. The medical group also provides primary care, HIV specialty care, and hepatitis C care for both addiction and non-addiction patients.
We sat down with Laura Maroldo to discuss the unique needs of her patients, how treatments for addiction have evolved in the last decade, and how Medly helps connect patients to the prescription medications they need.
At the core of Maroldo’s philosophy of care is the idea of treating patients like people. “I think you have to really understand that they're just people with a disease and just like any other disease, they're here for help.” She encourages anyone struggling with addiction to seek the treatment that they deserve. “You have the right to good medical care and you deserve the right to treatment for all of your chronic medical issues.”
Although she can only spend about half of her time with them due to the administrative demands of the job, Maroldo’s patients are her favorite part of her work. Her time with patients focuses primarily on HIV positive and/or hepatitis C positive cases, with hepatitis C eclipsing the number of HIV cases.
Maroldo’s career in healthcare began in high school, when she worked as a medical receptionist at a doctor’s office in her hometown neighborhood on Long Island. This office just happened to be, at the time, seeing the highest number of HIV positive patients in all of Long Island private offices.
“Patients were coming from everywhere on Long Island, CT, from Manhattan, Brooklyn, and Queens, mostly because of the stigma at that time that was associated with HIV.”
She explained that during this time, the early days of the AIDS epidemic in the 1980s, most clinicians were not interested in treating HIV positive patients.
At the time, she says patients fell into three categories of HIV infection: those who contracted HIV through blood transfusions or transplant, the gay male population and intravenous drug users. She says the first category were usually treated by their hematologist or oncologist.
Those addicted to drugs however were not receiving the same level of care.
“It became really apparent to me early on that those folks who were suffering with addiction really were unorganized and needed the most help.” She says the experience of seeing that need led her to want to do more.
“The doctor that I was working with, Dr. James Atkinson, really took me under his wing and taught me everything he could about HIV.”
Being medically licensed since the age of 23, Maroldo after attending the Touro Physician Assistant Program, she immediately focused on HIV and the substance-using population. She’s been doing just that ever since.
In the last 40 years since the AIDS epidemic, HIV has become something simpler to treat, while hepatitis still remains a challenge, which is the reason Maroldo focuses so much of her time on treating patients affected by it. Thankfully, there are effective treatments available for hepatitis C that are a world of difference from past therapies. “We were once treating hepatitis C with drugs like interferon that were really significantly difficult for patients to tolerate.”
Maroldo says these treatments were making some of her patients so sick they could not tolerate the treatment. “It's a whole new world now. The new medications are just so much easier to take and their side effects are minimal. Patients would be on an interferon for six, 12, sometimes 18 months. And now they're cured in eight or 12 weeks, which is incredible.”
On the addiction front, Maroldo is kept busy by a constant demand for therapy and treatment.
“What I see now is a huge influx of fentanyl and it's quite challenging because patients are not even aware that they're taking fentanyl.”
Overdose rates have significantly increased over the past few years and Maroldo says the demographics of addiction are changing with younger females coming in for treatment more than in the past. Although the number of addiction patients may not have improved over the years, the treatment options vastly have.
“I've been doing this now for 27 years, and when I started, there was no such thing as Suboxone or let alone prescription Suboxone, If you were coming in for medically assisted treatment, it was, it was methadone and you would have to come to a window every day and drink your methadone.”
In addition to Methadone at the OTP, her clinic uses Suboxone or other buprenorphine products to treat addiction, allowing patients to take their medication just as they would for any other disease. Much of the stigma to addiction treatment is removed when a patient can pick-up their medication at a pharmacy and be responsible for taking it themselves.
“That's a humongous change over the years. Now we have vitriol, which is a life-saving drug in my opinion, helping to prevent folks from overdose, especially when they're most vulnerable, right after detox.”
Telemedicine has transformed how care is provided at West Midtown. Today they use it to handle patient check-ins, some primary care and methadone dose evaluations. They also have the ability to do Suboxone inductions via telemedicine. During the height of the COVID pandemic, West Midtown remained open but decreased the amount of foot traffic within the office.
“We staggered staff and patient visits. We had every staff member come in one day a week and then they did telemedicine for the remaining four days.”
Since July of 2020, they’ve kept the same schedule of three days a week in-person and two days of telemedicine.
For the patients that are on hepatitis C or HIV medications, Maroldo uses Medly for all of their pharmacy needs.
“I have medications delivered to the office for our patients who are homeless or living in environments that are unsafe to keep their medicines. Medly has been really accommodating and assisting with all of that.”
Medly has been the pharmacy solution that Maroldo says she can trust for her patients’ unique medication needs. She first learned about Medly from another colleague who referred her to a Medly representative. She says the communication from Medly compared to other specialty pharmacies has been the best she’s experienced in her decades in healthcare, not only for her staff but also her patients.
“The Medly reps and internal staff do a really good job of communicating back any hurdles that they're facing or any challenges, which is really helpful, because we all know that those things can happen. I think that's probably where the biggest difference I’ve experienced. It's definitely different and much better than I've seen with any other pharmacy.”