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Addiction Medicine: Building a Bridge From Rescue to Recovery

News  |  By Debra Shute  
   March 01, 2017

Success key No. 1: Optimize the moment of crisis using a care continuum approach
"You have a very small window—of 48 to 72 hours—to try and get people engaged in ongoing management before they are likely to start backsliding," says Gregory Teas, MD, chief medical officer of the behavioral medicine service line for AMITA Health Behavioral Medicine, which includes Alexian Brothers Behavioral Health Hospital.

AMITA's addiction medicine services span a continuum of behavioral and medical treatments across a range of acute and ambulatory settings, says Ciha. "We are able to address every aspect of addictions at every level of care."

However, an organization needn't become a major behavioral health institution to play a key role in patients' recovery, Ciha says.

For example, systems can work closely with surgeons to build awareness of best practices in prescribing and monitoring postop pain medication, enhance physician education around pain management, and create pathways from various points of care to behavioral health resources.

With these steps, "and by being integrated with other providers, we are able to work collaboratively in the best interest of the patient to ensure we are not creating problems by eprescribing," Ciha says.

One of the opportune settings to convert rescue into recovery is the emergency department, says Kyle Martin, MD, medical director of emergency services at St. Mary's Hospital in Madison, Wisconsin, part of SSM Health, a nonprofit health system that includes 20 hospitals and more than 60 outpatient care sites.

The ED is where many patients suffering from addictions interface with the healthcare system, he notes. "A lot of them don't have primary care physicians, and aren't accessing care in any other way than through the ED, so that's really the only place we're going to be able to touch their lives," Martin says.

Outreach during that critical window can make all the difference. "I'd imagine people have seen some adverse effects of their addictions, but it's a powerful moment to wake up in the ED and have a physician explain that you were basically dead."

Martin's ED in Madison, which receives about 38,000 visits per year, saw more than 180 cases of opioid overdoses in 2015—or about one every other day.

Debra Shute is the Senior Physicians Editor for HealthLeaders Media.

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