South Carolina Emergency Department Response and Linkage to “On Demand” Community Based Treatment
This session will review the current Emergency Department-based interventions for treatment for Opiate Use Disorder and linkage to outpatient care for substance use disorders currently occurring within the state of South Carolina. The current programs in South Carolina include Screening, Brief Intervention, and Referral to Treatment (SBIRT), naloxone distribution programs, and ED buprenorphine pilot programs. Outcomes from these programs across the state and barriers to improvement of the current projects will be discussed. In collaboration with the South Carolina Legislature, South Carolina Department of Health and Human Services and South Carolina Department of Alcohol and Other Drug Abuse Services (DAODAS), the Medical University of South Carolina (MUSC) has established an emergency department-based pilot program to expand medication-assisted treatment (MAT) services for patients with opioid use disorder, based on initial efficacy and cost-effectiveness work done by D’Onofrio and colleagues. Layering on the SBIRT project, the intent of the pilot program is to identify opioid addicted patients through emergency department (ED) screening of drug and alcohol use, determine patients eligible for treatment with buprenorphine, and facilitate subsequent follow up with a provider for ongoing addiction treatment beyond the emergency department within 24 hours of ED visit. Additionally, through this pilot, take home naloxone reversal kits are available to any ED patient at increased risk of opioid overdose. Patients who screen positive for opioid use disorder receive a brief negotiated interview using motivational interviewing techniques. The goals of the brief interventions are to normalize the conversation around alcohol and drug use as a health issue. Brief interventions are an evidence-based technique proven to reduce or eliminate substance use and help patients get into needed treatment in a safe, confidential and accessible environment. Patients who are self-motivated and positively influenced to engage in substance abuse treatment are linked to care with community providers during their ED visits. Patients with opioid use disorder may receive a one-time dose of 8mg of buprenorphine during their ED visit and prior to discharge, are scheduled for next day follow up for continued addiction treatment.