Why Not Start Addiction Treatment Right In The ER?

After the fall of an oppressive and isolating regime, Portugal found itself utterly unprepared to deal with the rapid distribution of narcotics in the 1980s, creating a crisis that left 1 in every 10 people struggling with addiction. The country took a radical approach to rectifying opioid use through a huge cultural shift in the way it viewed and treated addicts - prioritizing support services and pioneering programs like needle-exchange and substitution therapy, and eventually decriminalizing hard drugs so that users could more easily get help, and drug rates have since plummeted.

The emergency room at Swedish Hospital in Edmonds, Washington is working to implement more focused care for those suffering from opioid addiction, an offering not typically present at most hospitals. Using a hands-on approach that integrates "substance use disorder treatment and interventions and assessment," through the use of doctors, counselors, and social workers, this program increases the likelihood of follow through with recovery.

In Utah, expanding health care access is taking shape in the form of RVs equipped with exam rooms, medical assistants and a nurse. Specifically designed to serve uninsured community members, the newest mobile health clinic offers "a specialized focus on women’s health, as well as mental health and substance abuse services, including medication assisted treatment which is used to help wean people of opioids."

The hub-and-spoke model allows local partners to provide individuals with access to resources earmarked specifically for opioid addiction treatment. The system of care, which uses regional clinics and non-profits as access points to treatment, has already proven effective in Vermont. Currently, a similar program is assisting individuals suffering from opioid addiction receive the help they need through entry points at nonprofits like The Doorway office at Harbor Homes.

Dr. Ross Sullivan, an ER doctor at Upstate University Hospital is trained in addiction treatment and has created a program in the emergency room to get overdose patients Suboxone while they wait to be admitted into inpatient treatment. Most doctors are unable to prescribe Suboxone for more than 72 hours, and most rehab facilities don't have room to admit new patients within that time frame. This solution allows patients seeking treatment for opioid addiction to access the care they need while they wait for more extensive treatment.

Studies show that people who received at least one dose of naloxone following an opioid overdose are 11 times more likely to survive. In response, state policies and community-level programs and organizations are working to make naloxone accessible to those who need it. Today, naloxone can be found in grocery stores, gas stations, provided at events like concerts and community spaces like libraries.

The Virginia Harm Reduction Coalition (VHRC) uses harm reduction strategies to help those suffering from addiction by providing free supplies like overdose reversal spray, safe smoking kits and clean syringes, as well as connection to education and treatment options when people are ready. Those who access services through a harm reduction program are five times more likely to enter treatment programs. Last year alone, the VHRC distributed more than 20,000 doses of Narcan which they know reversed at least 2,000 overdoses.

Agencies like the SHARE Center are beginning to hire peer support specialists, who are individuals who have lived experience of recovery from mental health conditions and substance use disorders. Peer support specialists provide non-clinical, strengths-based support and build trusting relationships with those in need of care. Since the COVID-19 pandemic, demand for peer support specialists has grown exponentially and reports show that working with a peer support specialist can improve health outcomes and quality of life among other benefits.

The Cowichan Wellness and Recovery Centre works to combat the ongoing overdose crisis. The Centre offers services like mental health support and a community hub where people can access, test and use drugs safely, as well as connect with healthcare, detox, and treatment services. Not only have these services benefited people, and connected them with others in the community, but they’ve also led to decreased criminal activity like theft.

The Journey to Recovery Community Center in Newport provides short-term, 24-hour peer support for people in crisis from substance use who want to begin their recovery. The Center not only works with those struggling with addiction but also aims to help reduce the strain on local hospitals’ emergency departments. The Center has since expanded to another location and received grant funding to continue scaling up its operations.