Addiction Treatment Should Begin in the Emergency Room. New Guidelines Are Making It Happen.

Jess Keefe
Doctors wearing surgery scrubs

Overdoses and infections often bring people with addiction into our country’s emergency rooms. For a long time, the best the ER could do for these patients was send them home with some Narcotics Anonymous pamphlets, or maybe the phone number of a rehab that doesn’t accept insurance. Without a well-coordinated plan for ongoing treatment, too many addiction patients don’t survive the next overdose.

Luckily, that’s starting to change. WBUR reports that in Massachusetts, a 2018 state law requires most hospitals and emergency rooms to offer medication to patients dealing with an opioid use disorder. Medication is proven by research to be the gold standard to treat opioid addiction: It eases withdrawal symptoms and drug cravings, stabilizes the body, and reduces the risk of fatal overdose.

But there are still barriers. Regulations require health professionals to jump through hoops to get specially certified in order to prescribe addiction treatment medications. The follow-up care that patients will need outside the ER is often a patchy network. And many professionals still feel confused or intimidated by the idea of treating addiction, buying into the harsh stigma of the disease.

That’s why the Massachusetts Health and Hospital Association (MHA) has issued new guidelines to help doctors problem solve. The guidelines give concrete examples of how emergency rooms can help initiate medical treatment for addiction and coordinate patient aftercare, from partnerships with local methadone clinics to hiring recovery coaches. State hospitals are now required to show that they are compliant with these guidelines in order to keep their licenses.

Many health professionals are excited about this new guidance. Vic DiGravio, president and CEO of the Association for Behavioral Healthcare, told WBUR:

"There's still a mindset out there that addiction is a moral failure, that people really don't want to get better. Unfortunately that stigma is not just in the general population but in parts of the medical community as well. So the hospital association saying this [is] something we can do and are excited to do, that sends a really clear message.”

Several other cities and states are following Massachusetts’ lead. The MHA guidelines are being used or piloted in places like Colorado, Buffalo, New Haven, and more.

The guidelines aren’t a silver bullet—the issues of billing codes, telemedicine coordination, and other factors still need to be addressed. But these guidelines are a big, important step toward bringing addiction care where it belongs: Into legitimate medical settings.

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