The District of Columbia Hospital Association works to advance hospitals and health systems in the District by promoting policies and initiatives that strengthens our system of care.
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D.C.’s opioid crisis remains at alarming levels, signified by the District’s 411 deaths due to opioid overdose in 2020 – a troubling 46% increase from 2019. Combatting this epidemic remains a priority of DCHA and the District. DCHA supports efforts led by Mayor Bowser and the Department of Behavioral Health to convene the Live.Long.DC initiative, uniting multi-sector stakeholders to identify and implement innovative solutions to end the City’s epidemic.
As part of these efforts, DCHA has been awarded grant funding to establish and implement Hospital-based Peer Programs in the Emergency Departments and Inpatient Units at The George Washington University Hospital, Howard University Hospital, MedStar Georgetown University Hospital, MedStar Washington Hospital Center, The Psychiatric Institute of Washington, Sibley Memorial Hospital, and United Medical Center. These Programs aim to identify and provide access to immediate substance use treatment for individuals with opioid use disorder (OUD). Evidence has shown that initiating early interventions, such as Medication for Addiction Treatment (MAT), at the first point of care saves more lives. The Programs also support extended wrap-around support for patients who use opioids and those who have experienced overdoses
Emergency Department and Inpatient Medication for Addiction Treatment Program
This Program ensures that persons with OUD can choose to accept treatment during their visit to the emergency room or hospital admission. The Program supports universal screenings to identify patients at risk for opioid and other substance use concerns. Those who screen positive are referred to a Peer Recovery Coach (PRC), a hospital employee who has lived experience with substance use or who has been professionally certified to serve in the PRC role. PRCs talk with patients, providing Brief Interventions to discuss substance use and opportunities for support and treatment. If patients indicate they are open to treatment, the hospital provides initial care before rapidly connecting patients to community-based provider(s) for sustained treatment. The program trains all appropriate hospital staff in the Screening, Brief Intervention, Referral to Treatment approach and emphasizes the value of patient connection with PRCs while still at the hospital to provide support for their treatment and recovery journey. PRCs also follow up with patients after they leave the hospital to verify if they were successfully connected to recovery support services.
The Program has leveraged the Mosaic Group’s model during planning and implementation. The Mosaic Group is a nationally recognized firm with experience working with hospitals to improve outcomes for patients with substance use disorders. The McClendon Center partners with DCHA to provide expertise in community outreach to pre-screen applicants for the PRC position, supporting hospitals in hiring for this role.
The McClendon Center also collaborates with hospitals to provide transportation services for patients being referred to community-based treatment.
Overdose Prevention Program
The Overdose Prevention Program furthers the goals of the initial contact between PRCs and patients at the hospital. This Program provides additional support for patients who use opioids, those at risk for overdose, and those who have experienced an overdose. Patients who work with PRCs in the Emergency Department or Inpatient Units are referred to an OPP Coach, who engages the individual directly in the community – wherever they may be. The Coach connects with the individual for 90 days, linking them to recovery support services like transportation, identification, health care, and other services. The Coach also conducts motivational interviewing to assess their willingness to change behavior. When the individual is ready, that OPP coach will connect them with a treatment provider.
patients with substance use disorder received a motivational interview to support behavior change
of patients with substance use disorder have been linked to community treatment providers
of opioid use patients who received medication for assisted treatment in the hospital were linked to follow up treatment