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ER’s Facing Challenge of Best Practices for Treating People with Addiction


ER’s Facing Challenge of Best Practices for Treating People with Addiction

Drug addiction and substance abuse along with mental health issues are sending people to hospital emergency rooms in increased numbers. Most doctors refer people to an addiction specialist, but this challenge is multi-faceted and requires a change in best practices to support people facing healthcare needs with addiction.

Reality of Addiction

People with drug addiction are generally struggling with overall health. Patients are marginalized from the health care system yet have nowhere else to go when they need help. If they need addiction medicine and support, there are concerns about how emergency rooms (ERs) can help them face this head on. One challenge facing healthcare providers at hospitals is whether offering addiction services might attract even more people seeking drugs, taking up valuable staff time and beds. With the increased demand for help facing opioid addiction, this is a reality facing many healthcare providers from hospitals to physicians and nurses. Most hospitals typically give ER patients with drug-related conditions the telephone numbers of local treatment clinics. The vast majority of more than 5,500 hospitals have so far avoided offering any form of addiction medicine to emergency room patients. Changes are emerging in this field with the recognition of the holistic approach needed to help those struggling with addiction.

Best Practices Changing

Outside of regular business hours when treatment facilities are closed, ER staff may give people their first oral dose of buprenorphine, hold for observation, then make an appointment for them with a treatment center the next morning. Once patients take buprenorphine, their mood changes almost immediately. One challenge is that drug use is so prevalent, emergency department’s standard protocol is to screen people for drug and alcohol abuse, no matter what they come in for initially. Some hospitals are providing the following:

  • A triage nurse asks questions about substances being used
  • Suspected addiction is treated with an initial urine toxicology screen followed by connection to a peer recovery coach on staff in the ER to see if they are willing to accept treatment
  • Attending physicians and nurses care for urgent medical needs followed by a prescription for buprenorphine.

When emergency physicians are not licensed to provide buprenorphine, a single dose of buprenorphine can be administered under what is known as the ‘three-day rule’ whereby a patient can be offered this medication with a 72-hour period. Life-saving drugs and recovery coaching can motivate patients to finish treatment at the hospital and make their way to a treatment center for addiction.

New Pathways

For many hospitals, it may make financial sense to help as many people as possible with addiction so they don’t have to keep going to emergency departments. With stigma waning for people struggling with addiction, and increased healthcare access, the barriers are coming down to treatment. Serenity Recovery Detox provides a safe, non-judgmental space, which provides helpful detox, treatment, and resources to get people on the road to recovery from addiction. Hospitals can continue to provide an elevated level of care for people with addiction by enhancing training and awareness of people’s needs up front so they can receive the best care possible, which helps everyone in the end.

Simple Recovery is a world-renowned, California state-licensed substance abuse recovery center. We offer dual diagnosis treatment, so if you are experiencing both substance abuse and symptoms of a mental disorder, call us today at 844-467-0267 so that we can work with you to restore your happiness, health, and well-being. You do not have to continue living this way; there are many people here ready to help you.