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How to Address Addiction in the ER

By Debra Shute  
   July 21, 2017

By connecting overdose patients with non-clinician 'recovery coaches' quickly, hospitals have a better chance of promoting long-term recovery.

For hospitals and health systems, truly treating substance abuse disorders means doing more than pumping stomachs, administering fluids, or giving emergency opioid-reversal drugs.

Such treatments, while life-saving, address only the surface of addiction.

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.

Optimize the Moment of Crisis

Outreach during the moment of crisis 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.

In the hopes of bringing overdose rates down, St. Mary's has launched a program modeled after the Rhode Island–based Providence Center's AnchorED, which deploys "recovery coaches" to the ED to counsel patients treated for opioid overdose and introduce them to resources for addiction recovery.

Debra Shute is the Senior Physicians Editor for HealthLeaders Media.

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