Hospital E.R.s Experiment With Opioid Treatment

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Every year, thousands of people addicted to opioids appear at hospital emergency rooms in withdrawal so agonizing it leaves them moaning and writhing on the floor. Usually, they’re given medicines that help with vomiting or diarrhea and sent on their way. Highland Hospital in Oakland, Ca., offers such patients buprenorphine.  One of three medications approved to treat opioid addiction, it eases withdrawal symptoms and cravings. Highland is among a small group of institutions that have started initiating opioid addiction treatment in the E.R., reports the New York Times. The aim is to plug a gaping hole in a medical system that fails to provide treatment on demand, even as more than two million Americans suffer from opioid addiction. “With a single E.R. visit we can provide 24 to 48 hours of withdrawal suppression, as well as suppression of cravings,” said Dr. Andrew Herring, who runs Highland’s buprenorphine program.

Locating a doctor who prescribes buprenorphine and takes insurance can be impossible in large swaths of the U.S. The wait for an appointment can stretch for weeks, during which people can relapse and overdose. A 2015 study at Yale-New Haven Hospital found that addicted patients who were given buprenorphine in the emergency room were twice as likely to be in treatment a month later as those who were handed a pamphlet with phone numbers. Herring persuaded the California Health Care Foundation to give a grant to Highland and seven other California hospitals to experiment with dispensing buprenorphine in E.R.s. Now the state will spend nearly $700,000 more to expand the concept statewide, part of $1 billion Congress approved for states to spend on addiction treatment and prevention under the 21st Century Cures Act. A few dozen hospital emergency departments, including in Boston, New York, Philadelphia, Brunswick, Me., Camden, N.J., and Syracuse, have started offering buprenorphine.

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