Years ago, when someone struggling with opioid dependency would show up in a Colorado emergency room after an overdose or as they were suffering through withdrawal, doctors and nurses would patch them up and send them on their way. “They came in and we made them feel a little bit better,” said Dr. Jason Hoppe, an associate professor in the emergency medicine department at the University of Colorado School of Medicine. “There wasn’t much we could do.”
What those patients wouldn’t receive is treatment for the underlying condition that brought them to the emergency room: their addiction. It’s part of a nationwide paradigm and practice shift that is a new first line of defense against an epidemic that killed 543 people last year in Colorado. Make more health reporting like this possible by becoming a Colorado Sun member. It takes just $5 a month.
“They in the emergency department have been seeing patients like this for a very long time. It’s frustrating, it’s dispiriting to see people struggling with an illness and not being able to help them or only being able to help them in the short term,” said Dr. Scott Simpson, a psychiatric emergency medicine doctor at Denver Health. “The difference that this makes for the clinician is huge because you feel empowered to treat this patient. The difference this makes for the patient is literally lifesaving.”
The Emergency Room
Now, doctors are starting to look at ways they might be able to use the on demand treatment model to help patients addict to methamphetamine; which is quickly becoming a more prevalent problem in Colorado than opioids. They are evaluate for opioid dependency and, if they meet the criteria, are then immediately offer medication to reduce their urge to use. That frequently is the drug buprenorphine, known by its brand name Suboxone.
The Outpatient Behavioral Health Services building at Denver Health, part of the hospital’s new Center for Addiction Medicine, provides medications such as methadone and buprenorphine to treat opioid addiction. In 2018, the first year Denver Health began offering its on-demand program; so it sign up 307 patients. In the first six months of this year, 258 people were brought on.
UCHealth’s University of Colorado Hospital in Aurora has been offering the service for just over a year. SCL Health’s St. Joseph’s Hospital in Denver has also been offering medication-assistance for about 12 months. Centura Health’s St. Anthony North has two emergency room; in Westminster that have been piloting a similar initiative since October 2018.
Medication to treat
“As more and more Centura hospitals across the state have caught wind of our model; so they’re interest in adopting it,” said Amber Quartier, a program coordinator overseeing the St. Anthony North program. Quartier said so far her program has consult in emergency departments with 120 patients, with about 30% of those receiving medication to treat opioid dependency and getting a handoff to a provider for further treatment.
Cristen Bates, director of communications and policy at Colorado’s Office of Behavioral Health; said studies have shown that people who begin taking medication to treat their opioid dependency; so in the hospital are more likely to stay in treatment and maintain wellness. That’s why the state has provide $800,000 in grants to UCHealth and Centura to get their on-demand treatment programs underway.
Bates said the state is now working with the Colorado Hospital Association to fund similar initiatives and other opioid treatment relate services at up to 10 other hospitals around the state. The idea is to ensure that when someone going through the throes of dependency enters the medical system, there are providers ready to help. “Any medical professional that they touch should be able to connect them” to treatment, she said.