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Battling opioid dependence in the Emergency Department

Emergency medicine professor says EDs can help prevent, identify and treat narcotics abuse

By Bryan Goodchild and Sandra Gray

UMass Medical School Communications

March 12, 2015

Emergency departments can play valuable roles in addressing the opioid abuse crisis, according to health psychologist Edwin Boudreaux, PhD.

“The ED prescribes lots of opiates in order to help people manage their pain,” said Dr. Boudreaux, professor of emergency medicine, psychiatry and quantitative health sciences, vice chair of research for the Department of Emergency Medicine at UMMS, and director of Behavioral Health Services at the UMass Memorial Medical Center-University Campus emergency room.

“Recent initiatives to standardize and improve the guidelines associated with prescribing opiates to patients in the emergency department are one way to help avoid people becoming dependent on them.”

In addition to prescribing practices that can help patients avoid becoming dependent on opioid medications, which is one path to opioid addiction, emergency departments can intervene with patients who already have problems with illicit narcotics like heroin as well as prescription opioids.

“There’s been a push to do a better job of identifying drug abuse problems in the emergency department because it’s a huge contributor, either directly or indirectly, to why people seek emergency care,” Boudreaux noted.

“We’ve been working on identifying ways we can use technology to more efficiently identify patients who might have opiate abuse or dependence, to help to guide the motivational interviewing that occurs whenever a clinician is talking with a patient, and to help best match the individual patient to a treatment facility.”

Boudreaux designed the software for the Electronic Brief Intervention and Referral to Treatment, which ED clinicians can use to screen for and assess the extent of substance use, provide brief motivational counseling and refer to treatment.

“Our software helps to identify the best referral resources in the community in terms of insurance, geographic location, the substance you’re abusing, and will actually fax a referral to an agency to make a next-day call to patient,” he noted.

“What we call a dynamic referral is the most powerful component of the intervention to actually get people in contact with specialists. It increases the probability that they will talk with an alcohol or drug treatment specialist over treatment as usual or just giving them a list.”

Hear more about preventing and addressing opioid abuse from Boudreaux in this Expert’s Corner video.

Related links on UMassMedNow:
Emergency Department a good place to help people who want to quit smoking
$12 million suicide-prevention study targets patients in the emergency room
Expert’s Corner: Maria Garcia on opioid addiction
Key role for pharmacists in stemming opioid abuse crisis