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BRUNSWICK — Mid Coast Hospital has announced a new initiative to help people engage in treatment to overcome opioid dependence.
The approach teams emergency department physicians and behavioral health providers in a collaborative effort that is showing positive results in its first several months.
The program, ED/ARC (Addiction Resource Center) Enhanced Referrals for Suboxone and Alcohol, is the first of its kind in Maine. Emergency physicians use newly developed treatment pathways to treat low-risk alcohol withdrawal, opioid withdrawal and a Suboxone pathway to begin patients on Suboxone while still in the emergency department. The program provides a screening tool for physicians, and it engages the department’s Behavioral Health Crisis Team.
“Combined substance abuse and mental health treatment with FDA-approved medication for opioid dependence has shown a significant increase in patient access and improved outcomes,” said Leah Bauer, MD, of the addiction resource center. “Medications stop withdrawal and relieve cravings so patients can have the best chance of engaging in successful treatment.”
Mid Coast Hospital’s ED/ARC Enhanced Referrals program has created a process to identify emergency department patients who are receptive to treatment, initiate the treatment process, and refer them to Mid Coast Hospital’s addiction recovery center for ongoing comprehensive treatment. In most cases, the patient leaves the emergency department with an appointment at ARC on the next business day.
“The model is based on taking advantage of the opportunity to intervene that an ED physician has when a patient with addiction presents,” said Ranjiv Advani, MD, of the emergency department. “If that opportunity is not seized at that moment, it may not present again.”
Maine, like many states, is struggling with how to stem the use of drugs, including opioids, and treat those who become addicted. In 2017, there were 418 drug-induced deaths in Maine, up 11 percent from 2016. Mid Coast Hospital is the only hospital in the state with an emergency department team providing Suboxone treatment to those presenting with opioid dependence, according to a news release from the hospital.
Before the initiative, there was no system in place for how best an emergency physician could help a willing patient access the services of the addiction recovery center. With its ability to schedule new patients promptly, ARC stands apart from many recovery programs in Maine that take weeks or months to access.
“The delay often is a deterrent for people who struggle with addiction,” said Bauer. “This ‘soft landing’ can be the difference for patients, especially those who have a narrow window of motivation to begin recovery.”
The Mid Coast Hospital team has screened many patients in the emergency department who are not ready or willing to engage in treatment. Between the start of the program in mid-October and the end of January, however, 11 patients were referred to ARC, and nine arrived for their first treatment session.
