FROM OUR CHIEF MEDICAL OFFICER

The Fewest Medicines That Work

Dr. Will Heise

Chief Medical Officer, Bumblebee health

When most people think of medical care at an addiction treatment center, they picture a prescriber, someone who signs off on charts and adds medications as needed. We try to do the opposite.

As a medical toxicologist, I spend my days treating overdoses, adverse drug reactions, and alcohol withdrawal. I see rattlesnake bites and kids who got into their grandparents’ pill organizers.

I know firsthand that medications carry side effects. That reality shapes our core philosophy at Bumblebee Health:

Polypharmacy is often where we start

By the time someone arrives at treatment, they’re often juggling a handful of medications. Some are psychiatric; others may be for chronic conditions they haven’t managed in years. Seeing a list of six or eight prescriptions is common.

Our job isn’t to make that list longer. It’s to understand it and, whenever safe and appropriate, shrink it.

I recently worked with a client who arrived taking three psychiatric medications on top of her medication-assisted treatment. By the time she finished our program, she was off two of them. Deprescribing is much harder than simply adding a fourth pill. It takes time. You have to know the patient, understand the drug interactions, and stay in close communication with the staff to track behavioral changes.

This is exactly why a program’s clinical coverage model matters. If a provider is spread too thin across too many facilities, they can’t safely reduce medications. When you don’t have the full picture, adding another drug feels like the safer choice, even when it’s the wrong one. That’s the system falling short, not the clinician.

Getting to the Root

Often, substance use is driven by an underlying, untreated condition. It might be anxiety that alcohol managed to quiet, or agoraphobia that drinking made temporarily bearable. If we treat that root issue, we give people a real shot at moving through recovery.

Let’s be clear: medication doesn’t cure a substance use disorder. Recovery involves a lot more than what we prescribe. It’s about changing thought patterns and stringing together small, positive choices to replace the poor ones. Medication is a critical support tool. It doesn’t do the heavy lifting for you.

But ignoring a highly treatable psychiatric condition makes recovery unnecessarily grueling. If someone has spent years self-medicating their anxiety with alcohol, a program that solely treats the alcohol use is missing the point.

Medical Care is Treatment

At Bumblebee, we treat diabetes, hypertension, schizophrenia, depression, and anxiety. We don’t do this just because it’s nice to have; we do it because these conditions dictate whether a person can stay in the program.

Consistent medical care is a luxury many of our clients haven’t had. When they finally receive it, they notice. Good care makes people feel safe and looked after. That’s not a fluffy, feel-good metric. It’s connected to whether a client is still sitting in group therapy in week three.

Why Care Works Best as a Team

This level of care doesn’t come from a weekly visit. It comes from a provider who stays in the conversation between appointments.

Your floor staff interacts with clients all day, every day. As medical providers, we might only see them for a few minutes. We rely on the staff to tell us what’s happening between appointments. Clients don’t always know what’s clinically relevant, and they’ll often confess things to a familiar tech that they’d never tell a doctor on a screen. That day-to-day context is pure clinical data. It tells us what to adjust, and more importantly, what to eliminate.

Ideally, our providers sit down directly with your team to build treatment plans together. We share our rationale, your team shares their observations, and nobody is left guessing. When it works, it doesn’t feel like two separate organizations. It just feels like one cohesive team caring for the same people.

The Real Question to Ask Clinical Partners

If you are shopping for a medical director, telemedicine, or telepsychiatry partner for your facility, stop asking how fast they can write a script. Instead, ask them how they take a patient off a medication.

Real life is messy, and the people we treat are incredibly complex. Not everything goes perfectly. But the trajectory has to be right. The ultimate goal is fewer medications and clients who build lives where they no longer need us.