Mayor Michael B. Hancock, Denver Health CEO Dr. Robin D. Wittenstein and Denver Public Health & Environment (DDPHE) Executive Director Bob McDonald today highlighted a new Treatment on Demand pilot program that offers patients, struggling with opioid misuse, medically assisted treatment the same day they come to Denver Health for support. The pilot, which began in December and will run through the end of 2019, has shown initial encouraging “next day show” rates for patients returning to continue therapy.
“We’ve heard first hand that those affected by opioid addiction or misuse want support, but face barriers to accessing the treatment that would help them. Treatment on Demand simplifies that access with the idea that there is ‘no wrong door’ to treatment,” Mayor Hancock said. “This strategy supports the development of an efficient and effective system to help connect people to the services they need when they are ready to make a change in their behavior and their lives.”
The Treatment on Demand program, which is staffed by on-call licensed therapists funded by DDPHE through the $430,000 included in the Mayor’s 2019 Budget, works with individuals to encourage them to enroll in medically assisted treatment when they go to the Emergency Department, and continue into Psychiatric Emergency Services. Previously, people seeking treatment for opioid misuse had to be referred for medical treatment in a process that could take as long as three weeks. A core function of this program is to increase access to immediate care and reduce the length of admission time at receiving outpatient clinics.
A person with opioid use disorder will typically go to the Emergency Department when they are experiencing withdrawal. Denver Health has one of the few Emergency Departments in the United States that already treats these patients with a drug called buprenorphine, which alleviates withdrawal symptoms and helps patients on the road to recovery.
Under this new pilot program, the licensed therapists conduct a “biopsychosocial assessment” of the patients, and, if clinically appropriate, enroll them into regular buprenorphine treatment the same day.
Before leaving Denver Health, patients are referred to one of three opioid treatment clinics. Patients are expected to go to the clinic every day to receive their dose of buprenorphine. They also receive psychotherapy and specialized medication management by trained physicians. The new program has already recorded 77 patients taking part in the program thus far, with a next day show rates of 73 percent. Before the licensed therapists joined the Emergency Department, patients referred to opioid clinics would show up 60 percent of the time.
“What is unique about this program is the dedicated therapists who work here make contact with people who use opioids as soon as they come into the ED. They enroll patients there and then direct them toward a pathway that hopefully leads to their recovery,” said Dr. Wittenstein
Part of Denver’s Opioid Response Strategic Plan currently being implemented by DDPHE, Treatment on Demand aims to eliminate barriers to those accessing treatment. The strategic plan lays out a series of goals supported by strategies and activities focused on to reducing stigma surrounding substance use, eliminating barriers to accessing treatment, ensuring equity, creating opportunity and building resiliency.
“After successfully engaging patients who misuse opioids and inducting them into relevant treatment programs, we must make every effort to help them remain in those programs to fully reap the benefits,” said DDPHE’s Bob McDonald. “We must continue to focus on creating opportunities for people who misuse substances to stay connected to vital services.”
Denver Health’s recently established a new Center for Addiction Medicine, a major new initiative which operates on the premise that every door to the hospital can lead to treatment of substance use. Patients have access to an array of treatment services including prevention and education, harm reduction, formal treatment and management of addiction disorders, along with post‐treatment services, and tools and resources that support ongoing recovery.