By Christine Ignaszak-Nadolny
A recent Sunday edition of The News contained an article highlighting the “very rare” treatment of opioid-addicted patients using buprenorphine in the emergency rooms of Highland Hospital in California. The “very rare” treatment they discussed is not rare here in Western New York.
Responding to the increasing frequency of opioid-addicted patients that he was seeing in his emergency room, Dr. Joshua Lynch initiated a change. As a career emergency physician at UB and Kaleida, he knew that when some of these patients were stabilized and discharged, the cycle of returning to the ER would be repeated. Lynch understood that providing the patient with the names and phone numbers of agencies that could provide supportive medical care was not proving effective. Battling addiction meant that many may not be able to return to a stable, safe home or have the transportation required to access follow-up care.
Worse yet, being in a depressed state may mean that they could not “make the call” to request help. If the patient or family did make the calls for help, often they were met with a long period of time before an appointment could be scheduled at one of the clinics.
Lynch knows that opioid addiction is a chronic disease requiring immediate aggressive treatment and management and therefore initiated a protocol of administering Suboxone at the time of ER treatment. But he didn’t stop there. He enlisted the help of his department chairman and emergency medicine colleagues. Recognizing that access to follow-up care was a problem, he approached local clinics and asked that they hold open appointment times for patients in crisis. Some were unable or unwilling to do so, because there was a history of patients not showing up for their scheduled appointments.
While patients were still in the ER, he personally began calling the clinics, emphasizing that the patient was “in crisis” and needed to be seen. Word got around that Suboxone was available in the ER of Millard Fillmore Suburban Hospital, and of his success in getting patients into care. With the help of Erie County Commissioner of Health Dr. Gale Burstein and funding by the Oishei Foundation, more hospitals have initiated Suboxone in the ER and more clinics came on board, with more appointments in the clinics becoming available. Currently there are more than 13 hospitals and 25 clinics working together to provide this “not so very rare” treatment plan here.
This is an example of regional partners pulling together and being willing to try new things to help patients. All participating hospitals and clinics should be recognized for their commitment to overcoming this horrible disease. Every patient needs to understand that care is available to them in Western New York.
Christine Ignaszak-Nadolny is executive director of the eighth district branch of the State of New York Medical Society.