Realizing our ability to address long-standing SUD in the ED flips the sense of hopelessness some SUD patients engender to a sense of opportunity.
As ED director at a small, rural hospital, I was contacted by the NM Bridge Program to learn about barriers to starting MAT in the ED and to ensuring transition to ongoing MAT in the community. As we talked, I realized that we already had a lot of key elements in place. About half of our providers have a DEA-X license. All of us look for opportunities to really treat the underlying causes of poor health. All of us have experienced patients with OUD returning again and again for issues such as altered mental status, skin infection or withdrawal. Just patching up the problem, addressing the most immediate complaint only, is frustrating and contributes to a sense of powerlessness and burn out. Our providers who have started patients with OUD on buprenorphine report high satisfaction, a sense of really addressing the patient’s medical needs. We have built close contacts with the primary care in our institution such that we can start a patient on buprenorphine with confidence we can get them established with a primary care provider who prescribes it. Realizing our ability to address long-standing SUD in the ED flips the sense of hopelessness some SUD patients engender to a sense of opportunity. Even when a patient opts not to start MAT today, educating them about the option (maybe next time) feels so much better than lecturing them about what they are doing to their health or barely addressing the SUD because it feels intractable.
Dr. Jason Kurland – ED Director