Fewer than 10% of people who were treated in West Virginia emergency rooms for non-fatal overdose were connected with medication-assisted treatment.
When people show up in the emergency room, they expect not only to be treated for the immediate problem, but to be connected with ongoing care. Someone with a broken arm, for example, can expect to have it set and leave with a referral to an orthopedist.
Yet, this system is failing people with substance use disorder, one of the most deadly medical conditions in the country.
According to a new study published in the Journal of General Internal Medicine, fewer than 10% of people who were treated in West Virginia emergency rooms for non-fatal overdose were connected with medication-assisted treatment, and just 15% were connected with counseling.
Although the study looked at just one state, the findings are symptomatic of failures in the medical system across the country, Andrew Kolodny, who directs opioid policy research at at Brandeis University’s Heller School for Social Policy and Management, told California Healthline.
He said, “There’s a lot of evidence that we’re failing to take advantage of this low-hanging fruit with individuals who have experienced a nonfatal overdose. We should be focusing resources on that population. We should be doing everything we can to get them plugged into treatment.”
Even the researchers were surprised by the low rates of ongoing treatment for opioid use disorder for patients who were clearly in need of treatment, said lead study author Neel Koyawala, a student at the Johns Hopkins School of Medicine.
“We expected more… especially given the national news about opioid abuse,” Koyawala said.
Dr. Margaret Jarvis, who works as medical director of a residential addiction treatment center, said that despite the prevalence of addiction, emergency room doctors often don’t know how to help people who present with substance use disorder.
“Our colleagues in emergency rooms are not particularly well-trained to be able to help people in a situation like this,” she said. Marissa Angerer visited the emergency department in Texas many times with substance abuse-related conditions. She was never offered ongoing intervention and was surprised when doctors didn’t understand what she meant when she said she was dopesick.
“They were completely unaware of so much, and it completely blew my mind,” she said.
When Angerer finally got into recovery, it was because she found a treatment center herself after having fingers and toes amputated because of an opioid-related condition.
“There were a lot of times I could have gone down a better path, and I fell through the cracks,” she said.