Looking to improve chances for survival for people addicted to opioids, Bristol Hospital has begun immediately starting them on Suboxone treatment and connecting them with recovery coaches and counselors.
The system, called medication assisted treatment, is intended to reduce the cycle of drug abuse, overdose and emergency room visits. Doctors believe that getting addicts more quickly into detoxification programs and rehabs will raise their prospects for recovery.
“The idea is to start a regimen of Suboxone and get them connected to practitioners and counseling instead of just stabilizing them and handing them a list of resources,” said Dr. Andrew Lim, head of the hospital’s emergency department.
Medication assisted treatment, known as MAT, has been spreading across the country, particularly in states where overdoses are on the rise. A report by the Centers for Disease Control and Prevention says Connecticut had 824 overdose deaths in 2015, 985 in 2016, 1,053 in 2017 and 1,066 last year.
About a dozen other Connecticut hospitals have instituted the MAT system in the past couple of years, including the St. Francis Hospital and Medical Center, Windham and Backus hospitals, Yale-New Haven and Midstate Medical Center. Kim predicted it will become a standard treatment in the addiction field nationally.
The treatment starts in the emergency room, where physicians traditionally were prescribing only short-term medications to reduce the symptoms of opioid withdrawal. Instead, the new system begins the addict on Suboxone right away.
“With Suboxone, you can get them feeling better physically, so you immediately take away the physical withdrawal and cravings that would typically drive someone to use,” Lim said. “The whole idea is that we can give them their first doses in a medically controlled environment — that gives us time to set up outpatient resources so they can see a recovery coach and a counselor as well.”
Bristol Hospital has worked with various mental health agencies, treatment centers and other health care providers to ensure that prompt appointments can be arranged in these cases.
“If someone comes in at 3 o’clock on a Tuesday, they can get an appointment the next day,” Lim said. “That’s the most important part — we can start 100 people on Suboxone, but if none of them have the appropriate outpatient followup, it’s futile,” he said. “MAT is really a long-term solution. So the patient needs to continue with a provider who will follow up with them, give them additional prescriptions, and arrange for detox, rehab and counseling.”
“They’re at the most vulnerable when they come to the emergency room. They’re like ‘I never want to do that again,’ but then they go back to their environment without a real plan for recovery,” said Lisa Coates, operations manager for the hospital.
“This offers a plan. ‘Here’s your outline for the next 30 days, you’ll have a recovery coach follow you, you’ll have a therapist provider to medically oversee the Suboxone treatment moving forward and learn how to manage your triggers in your environment so you don’t relapse, overdose and repeat the cycle,' ” Coates said.
“The biggest benefit of Suboxone is it allows people to live a normal life. They’re not dedicating their time and resources — and destroying the relationships in their lives — trying to seek heroin or make enough money to buy Percocet on the street,” Lim said. “They can actually have a life, a job. Eventually some people come off Suboxone, too.”