Drug overdose is the leading cause of accidental death in Washington –in 2017, there were at least 742 opioid-involved overdose deaths. To provide an important lifeline to patients at risk of opioid overdose, hospitals in Washington are implementing protocols to administer medication-assisted treatment (MAT) in the emergency department (ED). EDs are essential health care access points for patients with opioid use disorder (OUD). Patients with addiction frequently feel stigmatized and may avoid seeking primary care. EDs are crucial in providing safety. One way to support patients with OUD is to offer easy access to medication-assisted treatment (MAT) and assistance connecting with long-term recovery support.
The new protocols are similar to California’s ED BRIDGE program, which formalized a process for ED physicians and care teams to administer buprenorphine and engage with an interdisciplinary team to connect patients with ongoing support. Though timing is still an important factor in motivating behavior change, hospitals are helping patients contemplate recovery that includes MAT. Providers are also starting to rethink the role of EDs in reducing opioid overdose mortality in their communities.
EDs are among the most fast-paced and unpredictable health care settings. With already competing priorities for providers, the idea of implementing and sustaining a MAT program may seem like an insurmountable challenge. To garner momentum in beginning or furthering MAT programs, key components include:
• Acknowledging small steps towards success: Invite patients to share their recovery stories and providers to share experiences with the MAT protocol.
• Meeting patients where they are: Remove personal barriers by arranging transportation to and from appointments to enhance warm hand-off to outpatient treatment facilities.
• Making it a team effort: Various hospitals in Washington are committed to working together to share resources and offer best practices.
WSHA is asking EDs to implement protocols for MAT to increase access to lifesaving medication and hopefully reduce the number of opioid overdose deaths in Washington. WSHA is happy to help hospitals interested in this work, and can provide resources on screening patients, connecting with outpatient MAT providers, motivational interviewing, OUD stigma and other related topics. Please email Trish Anderson at TrishA@wsha.org to get started in treating ED patients with OUD.
