Emergency opioid program documents success
Peer participation a key part of bridge clinic
BY EMILY KULKUS
A program that uses medication and peer support is helping people decrease unsafe opioid use.
Ross Sullivan, MD, founded the Upstate Emergency Opioid Bridge Clinic in 2017 to help address opioid use disorder in Central New York. Opioid use disorder — of both prescribed medications and illegal drugs, such as heroin — has been a growing problem across the United States for many years. The pandemic only increased the number of lethal overdoses.
Sullivan, director of medical toxicology and an assistant professor of emergency medicine at Upstate, published a paper about the success of the bridge clinic in the Journal of Substance Abuse Treatment. The article, “Bridge Clinic Buprenorphine Program Decreases Emergency Department Visits,” drives home one of Sullivan’s primary goals and hypotheses about the clinic.
“I really wanted to publish it because I felt that it helps answer the question related to the biggest barrier, which is: ‘Do patients come to the emergency department more if we offer them buprenorphine or treatment?’” he said.
He estimates about 1,000 patients have been cared for through the bridge clinic. The article notes a 42% reduction in return visits to the emergency department among patients who completed a bridge clinic consultation.
Part of the treatment includes a medication to help patients who are abusing opioids and at risk for overdose. Buprenorphine decreases cravings and helps patients suffering from withdrawal.
Patients can be referred to the bridge clinic from any department within the hospital, but most are referred through the emergency department, Sullivan explains. Bridge clinic staff strive to have the first consultation appointment within one to three days after the initial referral. Bridge clinic services also include connecting patients to additional services in the community to help with food, housing, transportation and more.
A top priority of the clinic and its staff has also been to shed the stigma associated with opioid use disorder. That, combined with the social services offered by support staff provided by Onondaga County, called peers, has greatly contributed to the program’s success, Sullivan says. Peers are support specialists who are themselves in recovery and serve as a resource for individuals and families.
“The medicine is part of it, but the peers are the biggest part of it,” he says. “Having the peers is as important if not more important than anything else. We work with phenomenal peers.”