By Sam Prickett
A new initiative from the University of Alabama at Birmingham’s Department of Emergency Medicine is looking to approach the opioid epidemic in a holistic way, with the goal of reducing the number of opioid overdose deaths in Jefferson County by 30% over the next three years.
The emergency department’s medication-assisted treatment protocol will not only focus on immediate medical treatment of withdrawal symptoms, but also on connecting patients with support systems for long-term treatment and recovery. The program addresses a “big need,” said Dr. Erik Hess – a need the emergency department’s vice chair for research and a principal investigator on ED MAT said he recognized in his day-to-day work with patients.
“Every shift I was on, I would see one or two patients who presented with some sort of complication of or withdrawal from opioids,” Hess said. “We weren’t equipped to have the treatments that were effective while the patient was in the emergency department and hadn’t really made the connections with the community strong enough that there could be a hard hand-off for patients to get the treatment they need.”
That changed with a $1.5 million grant from the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration. Part of that money will go toward training physicians to administer naloxone, a drug also known as buprenorphine or Suboxone that can lessen opioid withdrawal symptoms for up to 24 hours. Licensed physicians can also provide short-term prescriptions and take-home kits of naloxone.
But a key part of the program comes after that treatment. Naloxone “decreases the cravings and provides (patients) with a degree of physiologic stability and well-being, and that really sets them up well to get engaged with treatment,” said Hess.
For that next step, the program will connect patients with a “peer navigator” — a person in sustained recovery who can guide the patient toward follow-up programs and treatments through the Recovery Resource Center of Jefferson County at Cooper Green Mercy Services.
That hand-off, Hess said, is essential in helping patients pursue treatment without fear of being stigmatized.
“Having interactions with someone who has not only been in your shoes before but who has already made it through to the other end of the tunnel and now lives a stable life … really meets the patient where they are in a way that hopefully overcomes that initial fear and stigma associated with interacting with the health care system,” he said.
“Simultaneously, those individuals who are in sustained recovery are frequently part of a long-term rehabilitation community, so it’s an opportunity to connect the patient with a community of individuals, and it’s really in the context of that community where those relationships are formed that sustained, significant life change can happen,” Hess continued.
Trying to Reduce Deaths
In 2017, 268 overdose deaths were recorded throughout the county, according to the most recent report from the Jefferson County Coroner’s Office. Over the next three years, the ED MAT program is anticipated to help 550 patients with opioid use disorder and to decrease the number of opioid overdose deaths in Jefferson County by 30%.
The program is the latest in a series of countywide initiatives to tackle opioid addiction. The Jefferson County Department of Health offers free training on how to properly administer naloxone to victims who may be overdosing on opioids. The mayors of Mountain Brook, Homewood, Vestavia and Hoover have all taken a proactive approach as well, hosting quarterly anti-addiction breakfasts featuring guest speakers and offering resources to those who are struggling with addiction or who know someone struggling with addition.
Ultimately, Hess said, he hopes the ED MAT program will encourage those struggling with opioid addiction to seek help.
“Really, all of us are susceptible to developing a dependence on opioids,” he said. “It really crosses all socioeconomic strata, and it’s not really an admission of weakness to seek help. It’s just a real admission of how powerful these medications are and how prone we are as humans to addiction … . We’re all vulnerable to some degree, and if it is something that you want help for, don’t hesitate to get it. None of us at UAB would think any less of any individual that sought help.”