A National Public Radio (NPR) story spelled it out more than two years ago. In “Why Not Start Addiction Treatment Right in the ER?”, they point out that these talented crisis providers act quickly to counteract the effects of diabetes or asthma at the moment the patient presents in the emergency room (ER). So, why aren’t these doctors beginning the process of treating an underlying addiction in the same way they would for any other disease?
Since that story was written, the opioid epidemic has forced the ER doctor right onto the front lines of the opioid epidemic. Too often, ER teams have to respond quickly to save an overdosing patient. What happens after the life is saved?
This article explores the ways in which ER physicians can help patients get on the road to recovery through accurate clinical assessment and a streamlined referral process. What are the benefits to patients?
ER Addiction Treatment – A Good Place to Start
Live Science reported on a study that tracked ER patients to determine if providing care for opioid addiction in the ER had an effect. The study tracked three treatment modalities in an ER setting:
- The physician provided a referral to a nearby treatment facility.
- The ER team provided addiction treatment counseling for 10 minutes and then referred the patient to a nearby treatment facility.
- The physician administered buprenorphine to counteract the effects of opioid withdrawal, counseled the patient for 10 minutes, and then gave the referral to a nearby treatment facility.
In one month, 78 percent of the third group, the one that received the medication, counseling, and the referral, were enrolled in an addiction treatment facility. Forty-five percent of the second group, who received counseling and the referral, were subsequently enrolled in treatment. Only 37 percent of the first group, who only received a referral, had made it into treatment.
Intervention can — and should — start in the ER.
While this is just one study, it provides startling insight into the role of the emergency room team in starting the recovery process. This should be heartening news for physicians weary of the episodic revolving door that the modern day ER has become for some patients.
The study also showed the effectiveness of buprenorphine as a tool for addiction treatment; patients who were given the drug reduced their use from 5.4 to just 0.9 days per week. Again, the third group showed better outcomes than the other two.
Increasing Addiction Treatment in the ER
Though this was one study in one hospital with a very small control group, extrapolating that data and applying it across the country as a new ER best practice could yield startling results for addiction treatment. The study appears to teach that:
- While ER doctors see substances users for a limited time in the ER, that contact could play a significant role in improving addiction treatment outcomes.
- The ER is a higher stress environment where the patient is likely scared about their health. ER docs can use the wake-up call of the ER room to counsel the possibly more receptive patient.
- Prescribing buprenorphine has a positive effect on treatment outcomes.
The ER physician clearly plays an important front-and-center role in addiction treatment. How physicians respond in these settings could move patients toward recovery or put them back on the treadmill of drug use. If you are an emergency medical professional looking for ways to help your patients successfully battle addiction, contact us to find out more about referring patients to our facilities.
