No one is surprised that there are many correlations between substance abuse and chronic health conditions such as cardiovascular disease, liver disease, pancreatic disease, and pulmonary issues, just to name a few. For example, in a very recent and somewhat surprising study, researchers found that methamphetamine users faced an 86% greater risk of being diagnosed with AFib. Similar jumps were also seen among cocaine users (61%), opiate users (74%), and cannabis users (35%). There are many additional examples that could fill up the page. However, the place where the rubber really meets the road is in emergency rooms. In a recent study led by Leslie Suen, MD of the University of California San Francisco Department of medicine, researchers found that one out of every eleven ED visits involved an individual with a substance abuse disorder.
Doctors and busy emergency room staff have few tools for effectively treating chronic substance misusers. While the care teams in emergency rooms are excellent at treating the physical trauma or wound, they often report feeling confused about next steps for chronic substance misusers. Administrative teams also report the billing for such treatment to be complicated.
The center of the universe for the American health care system is the hospital, creating a constellation for other medical services. Many health care related services such as medical offices, and other freestanding surgery centers are readily available and situated near the hospital.
Notably, this does not normally include addiction treatment centers.
Based on my conversations with strategic planning consultants, building addiction treatment centers is not on most hospitals’ strategic radar. This is unfortunate for the communities they serve. “Illness and death from complications of alcohol and other substance misuse are increasing nationally.” According to Suen, “Hospitals are one place where we can begin to reverse that trend, but we [hospitals] must be prepared to identify and treat these patients while they are in the hospital and continue following and treating them after they are discharged as well.”
The time has come for an integrated model of health care for patients suffering with addictions. Strategic planners have a role to play in encouraging their hospital clients not to overlook this community need. As one noted planner told me recently, “If you look in each community hospital’s CHNA, [Community Health Network Assessment] undoubtedly you will find an increasing need to serve those in the community seeking treatment for their addictions.”
We believe building the addiction treatment facility on the campus or within walking distance of the hospital would provide for a more seamless treatment experience for both the addiction and the associated chronic illness. It would first allow for better care coordination between emergency room physicians and addiction counselors, but would then continue to facilitate the relationship among psychiatrists, hospital specialists, and case workers. Importantly for the communities’ population, it would also better ensure that when the patients come to the addiction treatment center for medically-assisted treatment or partial hospitalization programs, they would also have the opportunity to see their physicians or nurses who are treating their chronic diseases.
While we continue to advocate for building treatment centers within a proximate distance to a community’s main hospital, we are seeing other creative approaches of collaboration from some leading hospitals around the country.
Here are some notable examples.
- University Hospitals, Ohio partnered with ThriveED to provide peer support services for patients with addictions beginning right at the bedside in the emergency department. Thrive can then provide case management services for those patients, and as a result UH now see much fewer readmits.
- San Francisco General Hospital. Almost half of SFGH patients have an addiction. Dr. Marlene Martin MD is the founder of, and still currently directs, the Addiction Care Team. ACT is an interprofessional consult service that provides compassionate care focused on harm reduction, evidenced based treatment and linkage to care for emergency departments with patients with unhealthy substance abuse.
- St. Luke’s University Health Network merged with Penn Foundation. Penn Foundation was a nonprofit community based behavioral health provider serving approximately 20,000 individuals annually. It operates one of Pennsylvania’s first Opioid Use Disorder Centers of Excellence. In conjunction with this increasing commitment of St. Luke’s to addiction treatment, St. Luke’s recently opened the region’s first level IV medical detoxification unit.
These initiatives demonstrate a growing realization that hospitals can play an important role in fighting our nation’s addiction pandemic. They represent green shoots of hope in our dream of better coordination between these important healthcare providers, while at the same time providing a competitive advantage to hospitals.
Hospital strategic planners should take note. In treating the whole person, a person with both chronic health disorders and substance abuse disorders, the collaboration between hospitals and addiction treatment professionals will be a key ingredient in our communities’ battles against the scourge of addiction. There is no better way to collaborate than to share a neighborhood. The strategic proximity between hospital beds and Intensive Residential Beds will be the difference maker in coordination and continuum of total patient care.
Incarnate Recovery develops, builds, and provides capital for medical and residential facilities exclusively for the addiction treatment industry. When it’s time to build a new facility for addiction treatment providers, Incarnate Recovery is a trusted partner to make it happen.
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