New nurse practitioner position at Upstate to focus on opioid addiction
Upstate University Hospital continues to dedicate more people and resources to the ongoing opioid crisis all the time. A great example of that is Theresa Baxter, NP, who was recently named to a newly created position at Upstate: Opioid Use/IV Drug Use Nurse Practitioner.
While working for Upstate pain service in 2014, Baxter said the team there began seeing more people admitted to the hospital who were also suffering from opioid addiction. Pain service helps patients manage pain after surgery or if they’re suffering from a painful condition. But if the person is already addicted to or is regularly prescribed opioids, treatment can be complicated, Baxter said.
She reached out to Ross Sullivan, MD, who founded the Upstate Emergency Opioid Bridge Clinic, which operates twice a week from the Downtown Campus. At the clinic, Sullivan prescribes buprenorphine, an opioid replacement (brand name Suboxone) to patients as they navigate their long-term treatment plan after discharge. Baxter went on to obtain a special license and additional education (some of which she received from Sullivan, a Department of Health-approved buprenorphine educator) to prescribe buprenorphine, which only a few providers at Upstate—and in the entire community—can do.
In her newly created position, Baxter is available full time to assist Upstate medical staff at the Downtown and Community campuses in identifying opioid addiction, managing medication and helping to coordinate long-term treatment options. Baxter’s pain service colleague, Sara Eckrich, NP, also works with this patient population.
“We see a lot of patients with diagnosed and undiagnosed opioid use disorder (OUD) and since we address all health concerns we address this as well,” she said. “Even if we don’t assist someone into treatment when they’re in the hospital or if they’re not ready to accept a diagnosis of OUD despite clear clinical signs of it, at least we’ve had the opportunity to provide information and available resources. It can be a difficult but necessary conversation.”
Upstate patients who might have opioid use disorder are evaluated and may be able to receive buprenorphine while in the hospital to curb the difficult and often physically painful opioid withdrawal symptoms. Easing the opioid withdrawal—which some people describe as being 100 times worse than having the flu—can help stabilize a person and help them feel better so they’re able to engage with treatment, Baxter said. Opioid use disorder and its deadly consequences have been on the rise for the last several years. According to the Centers for Disease Control, drug overdoses killed 72,000 people in 2017.
Sullivan, Baxter’s collaborating physician in her new position, said her expertise in this area helps Upstate patients on many levels.
“Before she started doing this, patients would routinely go back to or continue using drugs because they were not getting opioid replacement therapy,” Sullivan said in regard to patients being given medication in the hospital or at the bridge clinic. “This improves things in so many ways. Patients don’t leave the hospital against medical advice when they are engaged. They’re not angry, or sick and they can stay and complete the medically necessary treatment that brought them into the hospital.”
Securing treatment plans for patients with opioid use disorder can be challenging because outpatient treatment options in the community are limited. Both Sullivan and Baxter work with peer support specialists—people with shared/lived experiences and additional training that provide support and connections to treatment, housing, insurance, etc. Having medical staff such as Sullivan and now Baxter solely devoted to developing those plans—from prescribing medications to finding peer supports in the community – will reduce complications related to continued drug use and save lives.
Upstate Chief Nursing Officer Nancy Page, MS, RN, said Baxter brings a valuable mix of skills to the job that will benefit all of Upstate.
“Theresa brings a tremendous amount of compassion and expertise to her new position,” Page said. “That combination demonstrates what advanced practice nursing at Upstate can provide to a small but critical pool of patients. Theresa’s work will provide a specialized level of care for these patients to assist them to overcome addiction long-term and possibly save lives. Theresa is an ideal person for this position and our patients will greatly benefit from her care.”
Both Baxter and Sullivan also work with Upstate’s Addiction Medicine Department, which is headed by Brian Johnson, MD. Johnson said Baxter will continue being a valuable advocate for a population that needs her help and expertise.
“She’s been a titan of the Upstate staff,” Johnson said. “She recognized the need for her current position. She will save some lives by providing the service she does.”
In addition to addiction psychiatry, Baxter and Sullivan also work with medical and surgical teams, nursing, social work, case management and spiritual care to provide comprehensive care to patients.
“We’ve improved access in the community by doing these things,” Sullivan said. “It’s important for Upstate to be at the table and at the center of this issue.
“We’re treating addiction like the medical disease that it is. It’s important we treat those patients with fairness and respect. Just like we do every other patient that we serve.
The opioid use/IVDU team can be found on Amion, Upstate’s paging system.
Caption: Theresa Baxter, right, was recently named to a new position at Upstate: Opioid Use/IV Drug User Nurse Practitioner. Baxter works regularly with Ross Sullivan, MD, who founded the Upstate Emergency Opioid Bridge Clinic.