Hospital Emergency Departments Starting To Be Used in Opioid War

A California hospital has adjusted its approach, functioning as a gateway to short-term and, hopefully, long-term recovery.

Highland Hospital in Oakland is one of a small group of hospitals across the country that changed its approach to treating opioid patients who come to its emergency department. As the New York Times reports, it has begun to initiate opioid addiction treatment in the ED, starting with giving patients suffering from painful withdrawal symptoms a shot of buprenorphine.

Andrew Herring, MD, an emergency medicine specialist at Highland who runs the buprenorphine program, tells the Times that “with a single ER visit we can provide 24 to 48 hours of withdrawal suppression, as well as suppression of cravings. It can be this revelatory moment for people—even in the depth of crisis, in the middle of the night. It shows them there’s a pathway back to feeling normal.”

By giving patients who don’t usually seek medical care access to treatment with buprenorphine 24/7, the emergency department functions as the first step of what could possibly lead to recovery. 

Many doctors can’t prescribe buprenorphine for addiction because they need to first get a special license from the DEA. But as important as that step is, the program, called the hub-and-spoke system, goes further, the Times reports. The emergency department serves as a “portal, starting people on buprenorphine and referring them to a large-scale addiction treatment clinic (the hub), to get adjusted to the medication, and to a primary care practice (the spoke) for ongoing care.”

So far state officials like what they see, and have allocated $700,000 more to expand the $78 million concept statewide and have included two other addiction medications, methadone and naltrexone.