WA health officials turn to emergency rooms to combat opioid epidemic

Washington health officials announced a new program Monday to help emergency room clinicians prescribe medications to treat opioid addiction.

ScalaNW, a state health authority program, will provide 24/7 live clinical support to hospitals and emergency rooms looking to provide patients with medications for related disorders to the use of opioids.

The authority hopes ScalaNW will help doctors feel more comfortable prescribing medications like buprenorphine and methadone, which have been shown to be effective. Significantly reduces mortality rates for patients suffering from opioid dependence.

“Most people who die of an overdose have gone to the emergency room in the last 12 months,” said Liz Wolkin, program manager at the Health Care Authority. “So we know that the patients who could benefit from this are there. »

“The intention is not to send people there to receive treatment, but to recognize people who could benefit from it,” Wolkin added.

Hospitals that sign up for the hotline, offered in partnership with the University of Washington Psychiatric Consult Line, will also have access to 24/7 follow-up appointment scheduling, supported by the Washington Recovery Helpline and offered to patients before their discharge. from the emergency room.

For all hospitals in the state – not just those registered with hotlines – ScalaNW’s website, ScalaNW.orgwill provide clinicians with “evidence-based protocols for determining how and when” to provide medications for opioid use disorder.

So far, about 14 hospitals across the state have made progress in recruiting, Wolkin said, in more populous counties like Pierce and King, as well as rural counties where the outbreak has hit hard, like Okanagan . ScalaNW will be funded using approximately $970,000 in state opioid settlement funds allocated to the Health Care Authority during the 2023-2025 budget cycle.

Related: How WA counties are spending millions in opioid settlement dollars

“The goal of ScalaNW is to truly be a centralized, statewide resource, instead of each county or hospital having to bring together the staff, funding and resources to develop a program like this on his site,” Wolkin said.

Research suggests less than 9% overdose-related emergency room visits result in a prescription for opioid use disorder, despite the fact that an analysis of King County Emergency rooms have found that patients are much more likely to die from a subsequent overdose within 30 days of their hospital treatment.

The reluctance comes from a history of strict federal regulations on medications intended to treat opioid use, said Dr. Chris Buresh, an emergency physician at Seattle Children’s and an associate professor of emergency medicine at the University of Washington. Prescribing buprenorphine used to require additional training, and methadone is still highly regulated.

“It just made the drug seem more dangerous,” Buresh said. “There is no other drug of this type. I can prescribe life-threatening medications without any additional training.

Both drugs — particularly buprenorphine — are “extremely safe” for adults, Buresh said, adding that almost nothing is more dangerous than allowing someone to continue using fentanyl.

“People who use drugs are like you and me and everyone else. They are people and they deserve the best care we can give them,” Buresh said. “That’s what these drugs are for. And that’s what this website does.