A new program being implemented at seven ThedaCare Hospital Emergency Departments (EDs) provides help and hope for those experiencing an opioid use disorder.
The Overdose Response Protocol aims to help people safely recover from any level of inappropriate use of opioids such as fentanyl, heroin or oxycodone, explained Dr. Ezra Lyon, MD, Associate Medical Director for Integrative Addiction Treatment and Family Medicine Practitioner at ThedaCare Physicians-Waupaca.
“When a person comes to the Emergency Department, our teams take extra time to ask an additional question about that person’s opioid use during the intake screening,” he explained. “We hope that by asking the question, we can connect with people who may be experiencing an opioid use disorder and make it easier for them to seek help.”
If a person does respond to the question and it is determined they are experiencing an opioid use disorder, teams can encourage them to engage with the ThedaCare Overdose Response Protocol and get them started on a path to recovery Dr. Lyon explained. The Overdose Response Protocol works with people to get them into counseling immediately and prescribe medication if necessary.
Provisional data from CDC’s National Center for Health Statistics indicate there were an estimated 107,543 drug overdose deaths in the United States during 2023 – a decrease of 3% from the 111,029 deaths estimated in 2022. This is the first annual decrease in drug overdose deaths since 2018.
“While it is encouraging to see the decrease in opioid deaths, there is still work to do and help to offer,” Dr. Lyon noted. “These are premature deaths that could have been prevented. Since 2009, an increasing proportion of drug overdose deaths have been caused by opioids, especially since the introduction of fentanyl into the illegal drug supply.”
Fentanyl is similar to morphine but is 50 to 100 times more potent, according to the National Institute on Drug Abuse.
“Our hope is that people will see our Emergency Departments as safe places that can provide help when they are considering stopping the use of opioids,” Dr. Lyon explained. “The Overdose Response Protocol can help reduce the barriers for people to get help. There’s no judgment. Our goal is to try to keep people alive.”
Responding to Community Needs
Every three years, ThedaCare conducts a Community Health Needs Assessment in partnership with Public Health and many other stakeholders to help understand the health and well-being of communities, as well as what community members need to help achieve health goals.
“Improving mental health and reducing substance abuse are some of the highest concerns in all of the Community Health Needs Assessments we do in the communities our hospitals serve,” said Tracey Ratzburg, Community Health Coordinator for ThedaCare. “Addressing those concerns then becomes part of our commitment to improving the population health and well-being in our communities. The Overdose Response Protocol is an example of that commitment.”
The Overdose Response Protocol includes providing buprenorphine (Suboxone) under the care of an ED provider to help relieve any withdrawal symptoms. The protocol also connects the patient to a recovery coach through ThedaCare’s ED2Recovery program, and upon release from the hospital, sending the patient home with a HOPE Kit. That kit includes naloxone (Narcan) in case of an overdose, fentanyl test strips, a CPR mask, and information about local resources, including recovery groups and outpatient clinics that can continue medication. Many patients also receive a short-term prescription for Suboxone.
In addition, each patient is connected to a local medical provider for continuing consultation. Care team members follow up with patients to help them establish with a clinic in their area. The patients also receive ongoing support from their recovery coach.
Active in Appleton
ThedaCare Regional Medical Center–Appleton began expanded screenings in its ED in late January 2024.
“We have seen patients who have been identified as having a substance use disorder that we have then engaged in the Overdose Response Protocol,” said Dr. Sean McCloy, a ThedaCare Emergency Medicine physician. “Once a patient is identified as having an opioid use disorder, they are offered the opportunity to participate in the Overdose Response Protocol. We provide treatment, and then once they are stabilized for whatever condition they came to the ED with, we will release them with a HOPE Kit. The ED2Recovery Coach connection is a very important component of this program. It’s somebody who has been through what they’re going through and can provide guidance and encouragement.”
The Overdose Response Protocol is now being implemented at ThedaCare Regional Medical Center–Neenah and will be active at all of the ThedaCare Critical Access Hospitals in Berlin, New London, Shawano, Waupaca and Wild Rose by the end of 2024.
“I don’t want anyone else to die of this disease, which is what substance use disorder really is – a disease,” said Dr. Lyon. “We want our Emergency Departments to be safe places where people can get help and begin their recovery.”
The Overdose Response Protocol is a project of the Wisconsin Society of Addiction Medicine and is funded by the Wisconsin Department of Health Services. Dr. Ritu Bhatnagar from the Wisconsin Society of Addiction Medicine and Jill Lindwall, Quality Director with the Wisconsin Hospital Association have been instrumental in helping ThedaCare implement the Overdose Response Protocol.
