From Overdose to Engagement: Working with First Responders and Emergency Departments (1 CME)
(1.0 CME) In this conference recording from the 2018 Annual Conference, you will learn about how emergency department (ED) visits for opioid overdose have increased dramatically over the last several years, mirroring trends in overdose related mortality (1). In Indianapolis alone, our ambulance service—Indianapolis Emergency Medical Services—responded to over 2,000 opioid overdoses in 2016 and are on track to outpace that in 2017. Many local public health and safety agencies have championed increased access to naloxone and participated in trainings making it more widely available and accepted by first responders and community members (2). In Indianapolis, we created project POINT to help link those surviving an opioid overdose with the highest quality emergency care including warm hand offs to on-going treatment. Methods: We convened a group of experts and key stakeholders in our hospital system/community and undertook a quality improvement process to improve the care of overdose survivors while in the ED and through their transition to longitudinal care. Results: We developed a set of core ED services and a plan to implement each of them. Core ED services included: 1) brief assessment by a specialty trained outreach team member (ideally a recovery coach), 2) rapid HIV/hepatitis C testing, 3) naloxone teaching and provision, 3) harm reduction counseling, 4) referral to appropriate next level of care and 5) rapid ED follow up focused on recovery support, increasing/supporting motivation and overcoming logistical barriers. We also created a network of providers who were willing and able to accept our referrals and worked with them to optimize the referral process.
Conclusions: With the growing opioid epidemic, EDs and EMS systems are looking for novel and effective ways to reduce mortality and help bridge patients into recovery. EDs and EMS systems are used to working at all hours, in austere conditions with complex and often critically ill patients. We offer an expansive and largely untapped network of providers which could be brought to bear on this epidemic. Project POINT is one example of how the ED can help drive incremental change—even in areas of the country where access to high quality MAT is limited.
Melissa A. Reyes
Melissa Reyes, M.A., CRCMelissa Reyes completed her B.A. in Criminal Justice and Criminology at Ball State University in Muncie, IN. Following graduation, she worked as a case manager for the Madison Co. Problem Solving Courts for two years and was involved with both the Drug Court and Mental Health Court. In 2014, she then pursued her M.A. degree at Michigan State University in Rehabilitation Counseling. Melissa transitioned back to her home state of IN with the acceptance of a care coordinator position with Midtown Adult Addictions in Indianapolis, IN in September of 2016. The position was the forerunner of its kind for both organizations, and required constructing a unique collaboration between the community mental health center and Eskenazi Health ED; the area’s safety-net hospital. By January 2017, Melissa had accepted the role of Program Director for Project POINT (Planned Outreach,Intervention, Naloxone, and Treatment). Initially, POINT focused exclusively on providing referrals with warm handoffs, but Melissa expanded the scope and pursued a more holistic approach. This included promoting the start of implementing harm reduction counseling, rapid HIV/HCV testing as well as take home naloxone kits. In March of 2017, POINT expanded to include peer recovery coaching, and Melissa not only oversees the implementation of this new role, but also develops the training and supervision plan. Most recently, in January 2018, Melissa was offered and accepted the position of Project Director, Project POINT and Mobile Project POINT.
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 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 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 AMA PRA Category 1 Credit(s)™ for completing this course.