Opioid Treatment on Demand

In Oakland, CA there is an ER that treats opioid patients that are in withdraw with Buprenorphine on the spot.  This is starkly different than the treatment most opioid addicts get in an ER.  Most of the time, someone in withdraw that goes to an ER with severe symptoms will only receive treatment for those symptoms such as diarrhea and vomiting.  What Highland Hospital in Oakland does is to give the patients a dose of buprenorphine right away and then give them resources for follow-up care.

With 2 million suffering from opioid addictions and 50,000 who died last year from an overdose, we need to do all we can to help those who need the help.  As I have written about previously, we do not have enough doctors licensed to prescribe buprenorphine.  However, ER physicians do not have to have a license to give someone a couple of doses of buprenorphine to get them started on recovery.

“We don’t think twice about someone having a heart attack, getting stabilized in the ER and then referring for ongoing care from the cardiologist.”  The same can and is being done in some ER’s around the country.

Step 1: An opioid addict in severe withdraw goes to an ER for help, the ER physician prescribes a dose of buprenorphine and patient feels almost immediate relief.
Step 2: The patient is referred to a treatment clinic.
Step 3: The patient is also referred to a primary care physician for continuing care.

The one thing I need our Republican politicians to keep in mind is that this is a possible solution for states that have expanded Medicaid.  Buprenorphine costs $500 a month, making it out of reach for the uninsured.  I have heard so many politicians talk about the need to fight the opioid epidemic and in the same breath fight against a Medicaid expansion in Tennessee.  If we are all serious as a community about fighting the opioid epidemic then we absolutely have to expand Medicaid.

Goodnough, A. (2018, August 19). This E.R. Treats Opioid Addiction on Demand. That’s Very Rare.  The New York Times.

For further reading on the subject check out these related articles:

Goodnough, A. (2018, August 19).  In San Francisco, Opioid Addiction Treatment Offered on the Streets.  The New York Times.

Lamas, D. (2018, August 19).  An Overdose Left Him With Brain Damage. Now What? The New York Times.

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