One pilot program started with a safe-disposal receptacle for medications being installed in the main lobby at Southside Hospital in Bay Shore, NY. A contract was recently signed to have the receptacles installed at other Northwell hospitals, Kapoor says.
The other medication-disposal pilot program features Northwell's commercial pharmacy partner, Vivo Health Pharmacy.
Starting in November, all Northwell opioid medication prescriptions filled at a Vivo Health Pharmacy have gotten a special sticker on the bottle cap. The sticker has a message for patients, advising them that if they have any unused medication they can call the pharmacy, which will mail a safe-disposal pouch.
The pouches, which contain a neutralizing agent, can be used to dispose as many as 15 pills. Patients place pills in the pouch, add a few drops of water, then throw the pouch in the trash.
The safe-disposal pouches have been popular with patients and the program is expected to expand when new Vivo Health Pharmacies open, Kapoor says.
Opioid Addiction Treatment
In 2016, Northwell provided substance-abuse disorder services to 6,000 inpatients and 90,000 people in outpatient settings, says Jonathan Morgenstern, PhD, assistant vice president for addiction services.
At Northwell, which has five tertiary hospitals, 10 community hospitals, three specialty hospitals, and four affiliated hospitals, Morgenstern says most opioid-addicted patients follow a three-step trajectory:
- Inpatient detoxification for three to seven days to withdraw from physical dependence on opioids, usually with the assistance of medication such as Suboxone.
- Inpatient rehabilitation for 10 to 14 days. "Typically, when a patient comes out of detox, they are not experiencing withdrawal, but they are in a vulnerable and somewhat shaky state. … They need a protected environment and therapy," Morgenstern says.
- Outpatient services for three to six months, including medication and a combination of individual therapies to help patients transition from a protected environment back into their communities.
Even though treatment for opioid addiction can take months, most insurance plans cover the treatment and there is funding for uninsured patients, Morgenstern says. Under the Patient Protection and Affordable Care Act, substance use disorders treatment, including opioid addiction care, is considered an essential benefit that commercial plans must cover. Also, many states provide direct subsidies to SUD treatment programs to fund treatment for uninsured patients.
Christopher Cheney is the senior clinical care editor at HealthLeaders.