Patients with substance use disorder will be able to better connect with emergency department-initiated treatment programs at participating hospitals throughout the state, thanks to a partnership between West Virginia University Office of Health Affairs, Marshall University and the West Virginia Department of Health and Human Resources.
The project, Overdose Data to Action, aims to first screen patients in the emergency department for drug or alcohol use, then provide peer recovery support services, initiate medication-assisted treatment when appropriate, and refer them to treatment and support services that facilitate long-term recovery. The overall goal is to reduce overdose deaths and improve opportunities for people struggling with substance use.
Herb Linn, principal investigator for the project covering the northern part of the state, said the West Virginia strategy is modeled on the Mosaic Group’s Reverse the Cycle Program, which has been implemented in more than 30 hospitals across the country.
“The advantage of identifying a model program like Reverse the Cycle is that it’s comprehensive. From the time a person enters into an emergency department and presents for treatment, until they’re discharged into the community and linked to other resources,” Linn said. “It’s well designed and tested.”
This initiative expands on previous work between WVU and the DHHR Bureau for Public Health in which patients in the emergency department were connected to peer recovery support specialists. Linn said when the larger grant opportunity came along, he saw it as a bridge for patients to be connected to MAT and to longer term treatment in their communities.
A key component of the model is using peer recovery support specialists who have prior experience with recovery themselves, Linn said, which helps gain rapport with patients. For larger hospitals, peer specialists will be stationed on site. But for smaller hospitals with a smaller patient volume, on-call or telehealth options are being established.
“If the patient has opioid use disorder and they’re interested in treatment and express that they’re ready, they’ll be considered for getting an initial dose of buprenorphine,” he said. Buprenorphine can help decrease opioid cravings, which can lower the potential for substance misuse.
Further, patients can be referred to a local MAT provider for an appointment to continue treatment. The program also follows up through community outreach to make sure patients are going to their appointments, seeking additional peer support through meetings like Narcotics or Alcoholics Anonymous, or being connected to needed social services.
WVU is managing the project in the northern portion of the state, while Marshall is managing the southern portion. Participating hospitals currently include WVU Medicine Wheeling Hospital, WVU Medicine Camden Clark Medical Center, WVU Medicine United Hospital Center, Welch Community Hospital, Raleigh General Hospital, Beckley ARH (Appalachian Regional Healthcare), St. Mary’s Medical Center and Cabell Huntington Hospital. The project will continue to expand throughout other hospitals this year and next, and the grant has recently been extended to provide a fourth year of funding.
“Our Mosaic Group team is very grateful for the partnership to bring our Reverse the Cycle program to West Virginia hospitals and contribute to the efforts to impact the opioid crisis that has taken the lives of so many,” said Sadie Smith, Chief Program Officer of Behavioral Health for Mosaic Group. “We are seeing very positive results already in helping patients link to life saving treatment and look forward to our continued work together to expand the program in more hospitals.”
In each participating hospital, data are collected through electronic health records to determine how many patients are screened (with a goal of screening 100% of patients entering the emergency department), how many screened positive for alcohol or drug use, and how many are provided with subsequent services. The project is being evaluated in each county to determine whether there are changes in emergency response calls and overdose death rates.
Linn said the response from participating hospitals so far has been extremely positive.
“Providers and staff in emergency departments have been frustrated because they can only go so far in treating this condition among their patients,” he said. “This becomes an enhancement of the service they’re able to provide.”
Linn said he’s also encouraged by the way the program can help eliminate stigma against individuals with substance use disorder, even from health care providers. “With a program like this, minds are changed, however reluctantly. People see that these individuals can be helped.”
The principal investigator for the southern part of the state, Beth Ann Welsh, who is the Associate Director of Operations for the Division of Addiction Sciences in Family and Community Medicine with Marshall Health, said peer recovery coaches aid this effort by gaining the trust of medical professionals, giving them hope that others with substance use disorder can make positive changes, too.
“It’s an opportunity to work to better the community — one person at a time.”
Overdose Data to Action uses braided funding from the West Virginia Department of Health and Human Resources through the Center for Disease Control and Prevention Overdose Data to Action Cooperative Agreement (Award No. 6 NU17CE925014-02-02) and the Substance Abuse and Mental Health Services Administration State Opioid Response Grant (Award No. 1H79TI083313). The SOR program aims to address the opioid crisis by increasing access to medication-assisted treatment using the three FDA-approved medications for the treatment of opioid use disorder, reducing unmet treatment needs, and reducing opioid overdose related deaths through the provision of prevention, treatment and recovery activities.
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