Based on a bevy of hospital and police statistics, we know that there are a number of dire situations in which a person could find himself or herself when abusing substances. For instance, an individual could put his or her life or the lives of others in jeopardy due to being in a state of intoxication. A prime example of this is driving a vehicle while intoxicated. Another pertinent situation for drug users is an accidental overdose.
Every year, there are millions of hospital emergency room visits due to drug overdoses and other drug-related incidents. In fact, the high incidence of drug-related emergency room visits is one of the metrics used to show just how problematic substance abuse has become in the United States.
Traditionally, when someone experiences a drug overdose, hospital emergency departments provide treatment accordingly. If the drug is an opioid like heroin or prescription painkillers, the patient is treated with naloxone, which can block or even reverse the effects of opioids in the body.1 Similarly, individuals who overdose on stimulants are often given sedatives to counter the effects of the stimulant drugs. However, after receiving these life-saving treatments, individuals are simply sent away without hospitals attempting to prevent their continued use of illicit substances. While treating the actual overdose is essential, it seems that failing to provide any addiction education or offer patients the rehabilitative resources that are available today is a missed opportunity.
Why can’t hospital emergency rooms implement a similar intervention strategy for addicts as what is currently used for patients who suffer from heart attacks?
Inconsistent Treatment Strategies
From start to finish, heart attacks and drug overdoses are treated very differently in emergency rooms. When someone experiencing chest pain visits a hospital emergency room, the attending physician will use various machines and equipment to monitor the patient’s heart and confirm that his or her heart exhibits the damage characteristic of a heart attack.2 Once the heart attack is confirmed, the physician starts to look for the cause of the heart attack, whether it was the result of an unhealthy lifestyle or related to a bigger issue.
A patient who’s being treated for a heart attack will remain in the hospital under observation for up to four days, possibly even longer. After the cause of the heart attack has been identified, the patient is debriefed. He or she is given medications and prescriptions, detailed instructions for his or her recovery, and a referral to a specialist for follow-up/continued care. In short, not only is the patient’s heart attack is treated, he or she is also provided with all the tools needed to make sure that another heart attack doesn’t happen in the future.
When it’s an overdose that’s being treated, it often falls well short of that. The overdose victim is treated with naloxone, usually by the emergency responders. Upon being resuscitated, the individual is transported to a hospital emergency room so that a physician can medically monitor the patient before being released. In other words, individuals who overdose on drugs are provided with life-saving treatments and then dismissed, allowing them to quickly return to the very substances on which they’ve just overdosed. This isn’t to say that overdoses shouldn’t be medically treated. However, treating overdoses while failing to address patients’ addictions is akin to alleviating a symptom without addressing the actual problem.
Turning a Bad Situation into a Golden Opportunity
In 2011, there were more than 5 million drug-related visits to hospital emergency rooms across the U.S.3 with over 2 million of those visits are attributed to drug misuse and abuse.4 Of course, we should expect the number of drug-related emergency room visits to increase as long as rates of drug addiction continue to climb. It’s currently estimated that about 24 million Americans suffer from an alcohol or drug problem, representing approximately 9 percent of the U.S. population over the age of 12.5 Meanwhile, only about 11 percent of all addicts are receiving treatment.
According to these figures, there are about as many addicts in treatment as there are annual emergency room visits due to the misuse and abuse of drugs, which is very telling. Some have suggested that naloxone and easy access to overdose treatments have led many addicts to be less cautious about their drug use.6
However, a hospital in Indianapolis is leading the charge when it comes to turning an overdose into an opportunity for rehabilitation. Like other hospitals in the U.S., the Sidney and Lois Eskenazi Hospital in Indianapolis has been treating a growing number of drug overdoses every year. Moreover, staff members estimated that about 20 percent of overdose treatments were given to repeat patients, which is largely inspired the new strategy. Recognizing the intense vulnerability that patients feel after an overdose, the hospital implemented a pilot program called Project Point, which ensures that patients treated for drug overdoses are approached by a trained staff member for one-on-one recovery coaching.7
Due to the program’s positive reception and success, Eskenazi Hospital has brought on a team of full-time recovery coaches to provide even better mentoring and to help patients fully explore their treatment options. Aside from mentoring, Eskenazi Hospital offers overdose patients rapid hepatitis C tests and take-home naloxone kits to have on hand just in case. The ultimate goal is to address the actual disease of addiction by providing access to recovery resources. If even a fraction of the overdose patients took advantage of the recovery resources that hospital staff offers, the program would have a direct positive effect on the hospital’s volume of overdoses cases.
It’s disappointing that we’re only now seeing hospitals offer recovery coaching to overdose patients. Of course, an initiative like Project Point isn’t going to coerce reluctant addicts into treatment. Instead, such a program is meant to encourage those into recovery who already had some level of inclination. On the other hand, the experience of a drug overdose can be jarring and evoke interest in individuals who had no interest in treatment yesterday. Whether offering recovery coaching in hospital emergency rooms will make a huge difference or just a small one, the opioid epidemic has reached such levels of severity that we can’t afford not to try.
Written by Dane O’Leary