August 21, 2021 –  For years, Kayla West watched the opioid epidemic tear through her eastern Tennessee community. As a psychiatric nurse practitioner, she treated people with mental illness but felt she needed to do more to address addiction.

So in 2020, when the state created a position to help hospitals improve addiction care in the emergency room, West jumped at the opportunity.  But a growing number of emergency rooms and health professionals are trying to change that by developing new approaches that address the missed treatment opportunity in ERs.

“We know it’s possible because others have done it,” says Sika Yeboah-Sampong, an attorney with Legal Action Center and coauthor of the report. “You have a combination of levers and kinds of structures of how different cities, counties, states and even independent hospitals adopt these practices.”

These models have already been put in place in some big hospitals and small hospitals, rural areas and urban centers, those with ample resources and those on tight budgets, she says.

In Tennessee, West looked to several of them for helpful guidance as she developed a pilot program with one hospital she advises. “It’s like looking at a smorgasbord of options of where you can implement change,” she says. Here are just a few of the different strategies emerging from ERs across the United States:

Hiring advocates for patients in California

Daniel Browne started drinking alcohol and using prescription opioids at age 14. By the time he was 24, he was on the verge of losing his job, his car and his apartment.

“I didn’t know where else to go to get treatment other than the ER,” he says.

In May 2020, Browne drove 15 minutes from his home to Adventist Health Howard Memorial Hospital in Willits, Calif., where he was immediately met by Mary Anne Cox Gould. At the time, Cox Gould was a substance use navigator for a program called CA Bridge. She championed addiction treatment in the hospital and helped connect patients from the ER to clinics in the community. (Cox Gould is now a supervisor of other navigators in Adventist Health hospitals.  Cox Gould then walked him over to the hospital’s outpatient clinic and helped him schedule recurring appointments. When Browne ran into obstacles filling his buprenorphine prescription at a local pharmacy, she made the necessary arrangements for him to get it from the hospital pharmacy, instead.


[ninja-popup ID=12216]