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So like the rest of the nation, this opioid epidemic is pretty hard in Camden County and Cooper Hospital as the only tertiary care and level 1 trauma center in the region has really been the epicenter for patient care.
We had one patient who had a hundred and seventy-three narcan reversals in one year. That's a visit every other day.
The tendency in this country has been to treat patients with opioid use disorder by sending them to rehab and what we know is that this doesn't work.
These treatments are not successful.
What we do know is that we have evidence-based treatment and this evidence-based treatment is medication-assisted treatment.
By that, I mean buprenorphine, methadone and Vivitrol®.
When we started looking around, what we saw like much of the rest of the nation, is that we have a lack of MAT providers for patients with Medicaid and so what we had to do is we had to build our own.
About two and a half years ago, we opened our clinic, called the Outreach Clinic.
It's very unique. It's interdisciplinary. We currently have four physicians, as well as an addiction psychiatrist.
On top of that we have behavioral therapy and quite a bit of support staff.
We have a dedicated program for pregnant and postpartum women.
We co-locate with the HIV clinic and we also offer group therapy, individual therapy, as well as family therapy.
These patients who come to us with opioid use disorder and overdoses, are difficult to deal with in the emergency department.
In order to treat them in an evidence-based way, we had to change the culture in the emergency department.
We had to adopt medication-assisted treatment as the first-line treatment for these patients.
There are a couple steps that we had to go through. The first part, and probably the most important, was to get our physicians X waivered.
Our physicians, moving forward, were then able to prescribe buprenorphine.
The second step addresses the way that we treat withdrawal.
In the past, we have treated withdrawal with a cocktail of different medications, but the truth is that withdrawal should and is now treated with buprenorphine in our emergency department.
The physicians then identified willing patients who were ready and willing to start treatment at our clinic.
They gave them a limited supply of a prescription for buprenorphine, which was then refilled at our clinic.
So by having this program what we're doing is we're giving them these limited prescriptions which incentivizes them to follow up with the clinic.
It provides them with this evidence-based care. And then we take this care out of the emergency department and into an outpatient setting where it belongs.
Dr. Haroz came to me with the concept of all our faculty becoming educated and X waivered in the prescribing of medication to help bridge patients to definitive therapy.
It made perfect sense. I supported her a hundred percent. And I was very gratified that our entire group really stepped up and aggressively became X waivered in order to support not only our addiction services program, but primarily support our patients.
Yeah. I've tried everything. I've been to rehabs and halfway houses and this medication-assisted treatment is working, and my life is flourishing, and I've been sober for 19 months now.
So I think I was like many at first where I'm skeptical that we were just replacing one drug with another, and now that we have this tool, it's just made a world of difference with our patients.
They are normal functioning people again. You know they have a life, they have energy, they're just like you and me.
This is a medical condition just like anything else we treat in the emergency department... CHF... diabetes...
And these patients deserve the best possible care.
In the past we really had no care for these patients, so as ER doctors when we were able to link them to detox or rehab, we felt like superstars.
But you know what? That's only five to ten percent successful.
We know that we have evidence-based treatment that is actually 60 to 80 percent successful, and that is methadone, buprenorphine, and Vivitrol®, or naltrexone, medication-assisted treatment.
This is the right thing to do for the patients and that is our new standard at Cooper.