Success seen in Bridge Program for opioid use disorder

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PITTSFIELD — It has been seven months since Berkshire Health Systems began offering medical-assisted treatment to people with opioid use disorder at its emergency departments, and so far, the results have been successful, hospital officials say.

About 64 percent of the patients who were prescribed their first dose of buprenorphine — it's also known as Suboxone — at the emergency room have continued that form of treatment with the Brien Center, according to Dr. Jennifer Michaels, the center's medical director.

"It's been very successful," Michaels said of the Bridge Program partnership with BHS. "It eliminates the wait. When people need help, they need it immediately."

The Bridge Program, which launched in April, allows individuals who are experiencing an overdose, or want to begin medical-assisted treatment after business hours, to seek their first doses of the prescription at the emergency departments in Pittsfield, Great Barrington and North Adams. Those patients then are referred to the Brien Center to continue their treatment during the week.

Since the launch, 33 people have opted to start their buprenorphine treatment through the BHS emergency department.

Dr. Michael McHugh, who oversees the emergency department at BHS, said he didn't expect the patient follow-through to be as high as it is.

"That number is huge," he said of the 64 percent of patients who have continued in their recovery.

Before this program, patients were treated for their overdose in the emergency room, usually though an overdose-reversal drug like Narcan, and then referred for medication-assisted treatment at the Brien Center, Michaels has said. They often would decline the outside services.

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By getting the buprenorphine started for those who want it in the emergency room, it immediately will begin to fight cravings, help with withdrawals and get people moving toward a path to recovery, Michaels said.

After they get their first dose, there is no wait to be seen at the Brien Center, she said.

McHugh said that bringing medical-assisted treatment to the emergency department had required a culture shift.

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"I think that, for us, it was sort of a new way of thinking," McHugh said. "Traditionally, emergency departments had resisted Suboxone and methadone and those [prescriptions] that are specifically given out in specialty clinics."

But, a 2018 state law improved access to medical-assisted treatment in emergency departments across Massachusetts.

Last year, BHS staff participated in online training and certification.

The patients who have been prescribed the treatment at the emergency department generally have come in asking for it, he said.

Staff performs physical screenings and blood tests and then provides a dose of the medication. If it's the weekend and the patients can't be seen at the Brien Center until Monday, staff might prescribe them a dose to take home.

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"Typically, when we give out Suboxone, we also give out Narcan," McHugh said of the drug overdose-reversal medicine. "I couldn't be happier with how things turned out. The difficult part isn't the emergency department. We're open 24 hours a day. If you have a substance use disorder, the key component is the follow-up clinic."

Before the program launched, the team had been looking at national statistics about follow-up with similar services.

"They were around 60 percent," he said. "I think everyone was skeptical that we'd get a number that would be that high."

The follow-through in Berkshire County has surpassed that.

Michaels and the Brien Center staff have been working hard to make sure that individuals follow through, McHugh said.

"If the patient shows up in the emergency department, they're trying to track that person down," he said.

Haven Orecchio-Egresitz can be reached at horecchio@berkshireeagle.com, @HavenEagle on Twitter and 413-770-6977.


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