Anywhere, Anytime: Model for Universal Access to Opioid Medication Assisted Treatment (1.5 CME)
(1.5 CME) In this conference recording from the 2019 Annual Conference, you will learn:
|Opioid overdoses continue to climb. In 2016, 116 people died every day from opioid related overdose (NIDA, 2018). Medication Assisted Treatment (MAT) improves morbidity and mortality in patients with opioid use disorder, but only 10% of patients with a substance use disorder are in treatment (SAMHSA, 2017). Patients face many difficulties accessing MAT including stigmatization, wait times, difficulty finding a doctor, continued withdrawal, and payment limitations. Critically, patients are typically unable to access treatment at the moment they seek to stop using. The decisions to pursue sobriety often comes at the most inopportune times: for example, in the middle of the night when heroin dealers are available but admission to treatment is not. When they do encounter the healthcare system, most patients are left merely with a phone number to call. In order to facilitate access to treatment, Denver Health and Hospital Authority has developed a hub-and-spoke system leveraging a narcotic treatment program to facilitate access to MAT. To date in 2018, we have started 385 patients on MAT including from the emergency departments and psychiatric emergency service (n=181, 47%), jail and forensic settings (n=40, 10%), acute inpatient medicine (n=52, 14%), and a social detoxification service (n=32, 8%). Each referral source requires innovative clinical processes to identify patients with opioid use disorders, evaluate for MAT eligibility, and initiate treatment. In addition to being ideal for the patient, MAT-on-demand reduces the intake burden on outpatient services as well. With this model, Denver residents can access opioid MAT 24 hours a day�"there is no wrong door and no wrong time to access care. We present the development of this model in an integrated hospital and outpatient safety net system including clinical processes, staff training, and financing. A case-based presentation illustrates the process and unique challenges in connecting patients to care from different clinical settings. While the overall 30 day treatment retention is 48%, retention varies significantly by referral source, from 15% to 67% (p|
|1.) Describe challenges facing health systems and individual providers for delivering addiction treatment|
|2.) Describe how a Hub and Spoke Model facilitates patient’s entry into medically assisted opioid treatment and describe clinical dilemmas in the aggressive extension of MAT in highly acute medical and psychiatric care settings.|
|3.) Understand aspects of program developing including cultivating partnership with substance abuse treatment programs|
Dayan Dachel Colon Sanchez
|Dr. Dayan Colon Sanchez, is the Medical Director of the Methadone Clinic and Adult Substance Treatment Services at Denver Health and Hospital Authority, the safety-net hospital for Denver, CO. She went to medical school at Temple University and completed a general psychiatry residency and an addiction psychiatry fellowship at the University of Colorado. Dr. Colon Sanchez is passionate about improving access to Medication Assisted Treatment for patients with opioid use disorders.|
|Scott Simpson MD is Medical Director of Psychiatric Emergency Services at Denver Health Medical Center and Assistant Professor of Psychiatry at the University of Colorado School of Medicine. Dr. Simpson has published on the management of substance use disorders in the emergency setting and part of the Denver Health team that launced Colorado's first 24/7 buprenorphine induction program. Dr. Simpson is board certified in general psychiatry, addiction medicine, and consultation-liaison psychiatry.|
|Dr Hurley is an Infectious Disease, Addiction Medicine physician at Denver Health and Assistant Professor of Medicine at the University of Colorado. Her interest in substance care began after observing poor health outcomes for justice involved individuals at Denver Health Correctional Care Medical Facility. Her subsequent decision to pursue fellowships in Infectious Disease and then Addiction Medicine was motivated by the high prevalence of infectious disease and substance use disorders among individuals who are recently released from jail or prison. Her current position at Denver Health is supported by both Psychiatry and Medicine departments to increase treatment for individuals irrespective of where they seek care, be it the ID or methadone clinic.|
ACCME Accreditation Statement
The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
AMA Credit Designation Statement
The American Society of Addiction Medicine designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
ABPM Maintenance of Certification (MOC)
The American Board of Preventive Medicine (ABPM) has approved this activity for a maximum of 1.5 LLSA credits towards ABPM MOC Part II requirements.
ABAM Transitional Maintenance of Certification (tMOC)
This course has been approved by the American Board of Addiction Medicine (ABAM). Physicians enrolled in the ABAM Transitional Maintenance of Certification Program (tMOC) can apply a maximum of 1.5 AMA PRA Category 1 Credit(s)™ for completing this course.
ABIM Maintenance of Certification (MOC)
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn 1.5 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.