BRUNSWICK — People struggling with addiction often have few treatment options after they leave the hospital.
Mid Coast Hospital hopes to change that.
The hospital is the first in the state to launch a partnership between emergency department physicians and behavioral health providers working at Mid Coast’s Addiction Resource Center.
The program, called ED/ARC Enhanced Referrals for Suboxone and Alcohol, allows emergency room doctors to use newly treatment pathways to treat low-risk alcohol and opioid withdrawal. Physicians are also able to begin patients on Suboxone, a leading treatment for opiate addiction, while they are still in the emergency room.
The referral piece of the program allows physicians to identify emergency department patients who are receptive to treatment, and after initiating treatment, refer the patients to the resource center for ongoing care.
In many cases, the patient is able to leave the emergency room with an appointment at the Addiction Resource Center the next day.
Dr. Ranjiv Advani, medical director of Mid Coast’s Emergency Department, said the program is important because as the medical community sees more people with addiction coming in to seek treatment, local resources are also “drying up.”
Advani cited Mercy Recovery Center, which closed in 2015. He said Mid Coast physicians would often refer patients to the Westbrook facility for inpatient therapy.
“We would see people like this and really only be able to provide them with a phone number, and a ‘good luck’ and a handshake, and hope that they can find themselves the treatment,” he said.
Before Mid Coast’s collaborative program began, he added, such interactions were often discouraging for providers and patients.
“It’s somewhat of a dissatisfying interaction for the provider as well, because you’re sort of frustrated with your lack of options,” he said. “So this sort of turns that upside down and gets our providers more engaged with the program.”
Mid Coast’s program is based on a 2015 study conducted by Yale University researchers. Dr. Leah Bauer, a psychiatrist at Mid Coast’s Addiction Resource Center, said the hospital’s results have been mostly “on par” with the study’s findings.
Bauer said the Yale report suggests about 80 percent of patients who were offered such intervention remained in treatment 30 days later, which is the approximate statistic Mid Coast has seen over the last eight months.
“People have been showing up. It seems to be pretty much the same patient population that we were already treating,” she said. “It’s just that we’ve been able to really shorten that window of time between when patients are seeking help and when that help is given to them.”
Shortening that window is crucial, Bauer added, and a contrast from other inpatient facilities which often have long wait lists, delaying treatment for weeks or months.
“Addiction is all about motivation, it’s all about intervening at the time of high motivation, and motivation is fluctuating all the time,” she said.
Even during the two-day delay, however, which Advani said can be “an eternity” to those struggling with substance abuse, patients involved in Mid Coast’s program receive medical treatment to curb withdrawal symptoms.
“The great thing is, during those two days those people are on treatment, so they’re not suffering withdrawal for even two days when minute to minute, hour by hour there’s a strong urge to use,” he said.
In addition to being the first program of its kind in Maine, the Mid Coast program is also innovative for New England.
Bauer said Massachusetts General Hospital now has a similar program, but Mid Coast’s began before the Boston initiative was launched.
On a national scale, Advani said he is aware of “a handful of others” around the country, but through attending national conferences he’s learned not many other hospitals have their own collaborative programs.
Part of the issue, he said, especially with other Maine hospitals he’s spoken with about the effort, is that many other facilities do not have addiction resource centers to partner with.
To get the word out and motivate others, Advani and Bauer said they are “taking the program on the road,” by presenting to other medical providers in a variety of ways.
Ultimately, Advani said he is proud of the program and the providers involved.
Since those struggling with addiction are a “traditionally underserved population” subject to judgment, he added, he hopes the new program cuts back on the stigma that “travels with” such patients, too.
Bauer echoed that sentiment, and added even for those who may not be ready for treatment, she hopes Mid Coast’s program can “shift the paradigm” around addiction care and make patients more comfortable.
“I think a lot of times patients, particularly with substance use disorders, are used to coming in and being treated in a certain way that doesn’t leave them feeling good about themselves,” she said. “I think that this really plants a lot of seeds of hope, and of, ‘hey there’s something that can actually help me, next time I’m really ready for help, I’m just gonna go there.'”
Dr. Ranjiv Advani, medical director of the Mid Coast Hospital Emergency Department, left, and Dr. Leah Bauer, a psychiatrist with Mid Coast’s Addiction Resource Center, are part of a program that allows patients to begin treatment for substance use disorder while still in the Brunswick hospital’s emergency department.