Question: What is being done at Barnes-Jewish Hospital and Washington University School of Medicine to address the opioid crisis?
Robert F. Poirier Jr., MD, MBA, Assistant Professor, Emergency Medicine, Clinical Chief of Emergency Medicine, and Director of ED Patient Safety, Quality, and Performance Improvement
At the end of 2016, we started a program called EPICC (Engaging Patients in Coordinated Care). In the past, when someone with an overdose came into the emergency department, we would resuscitate them, give them a piece of paper, and say, “Call a number on here and try to get into rehab or follow-up.”
The problem is that this doesn’t work. The way that addiction works is that as soon as we reverse the effects of opioids in someone’s body, all of a sudden a craving overtakes them. The addiction is so strong that they immediately want to go back out and get to where they were before.
We started the EPICC program as a pilot program at the Barnes-Jewish Hospital emergency department. When someone comes in with an overdose, we call a recovery coach. The recovery coach, who is often a former addict, gives these patients the hope that they can make it through, because often there is no hope out there. We then connect the patient within a day or two to a substance abuse treatment center.
We started to operationalize this plan in December 2016. In May 2019, at Barnes-Jewish Hospital, we referred 90 patients to get into treatment. My goal is to get that up to 150 to 160 per month, but we’ve made great strides.
The good thing is, the percentage of patients who are referred to EPICC and then agree to work with a recovery coach is very high. This referral-to-enrollment rate at Barnes-Jewish Hospital is 95 percent.