LEXINGTON, Ky. (Dec. 13, 2017) – Many people with opioid use disorder (OUD) come in contact with the health care system for issues related to their illicit opioid use. Often, people present to the emergency room with an opioid overdose, or superficial or deep-seated infections due to injection drug use. Many of these infections require lengthy hospitalization and sometimes surgical intervention.
When patients receive treatment for medical complications related to OUD and injection drug use, they may not receive treatment for the underlying substance use disorder. By failing to address the underlying cause of the medical complications, patients remain vulnerable to reinfection, readmission and death.
When the state began looking for ideas to address the opioid epidemic in Kentucky, Drs. Sharon Walsh, Michelle Lofwall and Laura Fanucchi submitted a plan to help patients who were engaging with the medical system enter treatment for OUD.
Through the new First Bridge Clinic, located at the University of Kentucky Center on Drug and Alcohol Research, Walsh, Lofwall and Fanucchi are creating a new setting where patients can receive evidence-based care for OUD. Patients may receive FDA-approved medications for opioid use disorder, counseling services and monitoring aimed to promote remission and recovery.
"An essential part of the substance use disorder treatment system is to be able provide treatment-on-demand rather than sending patients who are at risk for overdose death to treatment waiting lists," Fanucchi said. "This way we can engage patients and link to treatment at the moment of contact with the health care system, and hopefully reduce substance use related morbidity and mortality."
In partnership with the emergency departments at UK HealthCare and with financial support from the state through the 21st Century Cures Act, Walsh, Lofwall and Fanucchi are creating a clinical setting where providers in the emergency department can refer patients to receive transitional care for OUD. “We’re developing a new clinic and it’s going to partner closely with the ED so when patients are referred they can receive care rapidly and within the same health care system with the aid of peer support,” Walsh said.
Additionally, Walsh, Lofwall and Fanucchi will share information with facilitators from the two other sites in the state also awarded funding to create similar clinics.
"The need for this clinic is clear," Lofwall said. “If the underlying addiction isn’t treated the person goes back to active addiction and is at very high risk for death and/or reinfection requiring another hospitalization with complicated medical and surgical treatments.”
In creating this new multidisciplinary service, the UK team is hoping to positively impact the opioid epidemic by expanding and improving access to recovery services for patients.