Delaware’s Department of Health and Human Services is changing the way emergency rooms in the First State treat those suffering addiction.
The Emergency Department Opioid Use Disorder Treatment Guidance document is meant to be shared across Delaware emergency departments to standardize how emergency room clinicians approach those dealing with addiction.
Emergency room staff from several Delaware health systems say the old methods were outdated. They note the severity of opioid withdrawal, the difficulty treating it, and the lack of transfer of care often caused patients to make recurring visits to their ERs.
Jeni Dixon is in recovery and agrees previous methods weren’t enough.
“I went to the hospital for help with very serious xylazine wounds. I experienced an extremely difficult withdrawal because of being given suboxone only a few hours after my last use, which sent me into precipitated withdrawal. Because I was in so much pain and
discomfort from this, I left against medical advice and ended up returning to drug use to make the pain stop.” she said.
The updated Emergency Department Opioid Use Disorder Treatment Guidance document seeks to bring ERs across the state up to date on best practices involving screening, overdose care, patient engagement, documentation and billing.
Also being overhauled is the transferal of care from emergency departments to support system organizations. ER doctor Lee Colaianni says previous practices often let people fall through the cracks
“And that’s kind of what’s been happening. Even when I was training -which wasn’t that long ago- after we gave Narcan we’d wait 90 minutes, and if they’re not hypoxic, in low oxygen, we’d say ‘bye-bye, that’s it, be on your way, you’re taking up a bed’ and that’s a shame.” he said.
Several healthcare providers report already using the Delaware Treatment Referral Network, but new regulations suggest emergency departments consider a “care navigator and peer” position be created.
This position would facilitate referrals from the ED to community treatment organizations, and the state recommends this person be someone that’s experienced overdose before.
The peer model is based on research that suggests it makes those in addiction more receptive to considering recovery.
Delaware remains one of the top three states for overdose deaths, but DHSS hopes to see a decline when it shares data again next year.
