{"id":12589,"date":"2023-03-27T18:31:21","date_gmt":"2023-03-27T18:31:21","guid":{"rendered":"https:\/\/blogs.cooperhealth.org\/ehealth\/?p=12589"},"modified":"2023-03-27T18:31:21","modified_gmt":"2023-03-27T18:31:21","slug":"ndafw-emergency-medicine-and-hospital-based-addiction-care-available-at-cooper","status":"publish","type":"post","link":"https:\/\/blogs.cooperhealth.org\/ehealth\/2023\/03\/27\/ndafw-emergency-medicine-and-hospital-based-addiction-care-available-at-cooper\/","title":{"rendered":"#NDAFW: Emergency Medicine and Hospital-Based Addiction Care Available at Cooper"},"content":{"rendered":"<p><span style=\"font-weight: 400\">Yesterday was the last day of <\/span><a href=\"https:\/\/nida.nih.gov\/research-topics\/parents-educators\/national-drug-alcohol-facts-week\"><span style=\"font-weight: 400\">National Drug and Alcohol Facts Week\u00ae (NDAFW)<\/span><\/a><span style=\"font-weight: 400\">, an observance that encourages dialogue surrounding substance use and substance use disorder (SUD).<\/span><\/p>\n<p><span style=\"font-weight: 400\">As part of NDAFW, the <\/span><a href=\"http:\/\/cooperhealth.org\/recovery\"><span style=\"font-weight: 400\">Cooper University Health Care Center for Healing<\/span><\/a><span style=\"font-weight: 400\">, a State of New Jersey-designated Medication for Addiction Treatment Center of Excellence (MATCOE), shared content on the Cooper eHealth Blog to educate providers, interdisciplinary care teams, patients, and communities across Cooper, the region, and the state on SUD and available treatments at Cooper:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/bit.ly\/ndafw032023\"><span style=\"font-weight: 400\">How the Cooper Center for Healing Supports Our Patients and Communities<\/span><\/a><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/bit.ly\/ndafw032223\"><span style=\"font-weight: 400\">Medications for Substance Use Disorders, Increasing Access to Treatment, and Decreasing Stigma<\/span><\/a><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/bit.ly\/ndafw032323\"><span style=\"font-weight: 400\">Perinatal Substance Use Care at the Cooper Center for Healing<\/span><\/a><\/li>\n<li style=\"font-weight: 400\"><a href=\"https:\/\/bit.ly\/ndafw032423\"><span style=\"font-weight: 400\">Full Coverage Substance Use Disorder and Mental Health Care for Uninsured and Underinsured Patients at the Cooper Center for Healing<\/span><\/a><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">Please find additional content on emergency medicine (EM) and hospital-based addiction care services available at Cooper below, and follow MATCOE social media networks on <\/span><a href=\"http:\/\/twitter.com\/SNJMATCOE\"><span style=\"font-weight: 400\">Twitter<\/span><\/a><span style=\"font-weight: 400\">, <\/span><a href=\"http:\/\/linkedin.com\/company\/snjmatcoe\"><span style=\"font-weight: 400\">LinkedIn<\/span><\/a><span style=\"font-weight: 400\">, and <\/span><a href=\"http:\/\/instagram.com\/snjmatcoe\"><span style=\"font-weight: 400\">Instagram<\/span><\/a><span style=\"font-weight: 400\"> for ongoing updates in regard to educational and clinical content and resources available.<\/span><\/p>\n<h2><b>Medication for Addiction Treatment Pathways<\/b><\/h2>\n<p><span style=\"font-weight: 400\">The Cooper University Health Care Emergency Department Addiction Pathways (CUH EDAP) program, also known as the Cooper ED Bridge program, combines medication for addiction treatment (MAT) by EM physicians and referral to longitudinal care with the goal of facilitating long-term engagement in evidence-based addiction medicine.<\/span><\/p>\n<p><span style=\"font-weight: 400\">In 2016, Cooper&#8217;s Division of Addiction Medicine partnered with the ED to train all EM physicians and residents in buprenorphine medication for opioid use disorder (MOUD). The department chair mandated the formerly required &#8220;X-waiver&#8221; training and certification of all ED medical faculty to promote evidence-based treatment of patients with opioid use disorder (OUD) on the front lines.<\/span><\/p>\n<div id=\"attachment_12592\" style=\"width: 2570px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/blogs.cooperhealth.org\/ehealth\/files\/2023\/03\/SMC-EDAP-Launch-June-2021-scaled.jpeg\" rel=\"lightbox[12589]\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-12592\" class=\"size-full wp-image-12592\" src=\"https:\/\/blogs.cooperhealth.org\/ehealth\/files\/2023\/03\/SMC-EDAP-Launch-June-2021-scaled.jpeg\" alt=\"Patient education materials\" width=\"2560\" height=\"2560\" srcset=\"https:\/\/blogs.cooperhealth.org\/ehealth\/files\/2023\/03\/SMC-EDAP-Launch-June-2021-scaled.jpeg 2560w, https:\/\/blogs.cooperhealth.org\/ehealth\/files\/2023\/03\/SMC-EDAP-Launch-June-2021-300x300.jpeg 300w, https:\/\/blogs.cooperhealth.org\/ehealth\/files\/2023\/03\/SMC-EDAP-Launch-June-2021-1024x1024.jpeg 1024w, https:\/\/blogs.cooperhealth.org\/ehealth\/files\/2023\/03\/SMC-EDAP-Launch-June-2021-75x75.jpeg 75w, https:\/\/blogs.cooperhealth.org\/ehealth\/files\/2023\/03\/SMC-EDAP-Launch-June-2021-768x768.jpeg 768w, https:\/\/blogs.cooperhealth.org\/ehealth\/files\/2023\/03\/SMC-EDAP-Launch-June-2021-1536x1536.jpeg 1536w, https:\/\/blogs.cooperhealth.org\/ehealth\/files\/2023\/03\/SMC-EDAP-Launch-June-2021-2048x2048.jpeg 2048w, https:\/\/blogs.cooperhealth.org\/ehealth\/files\/2023\/03\/SMC-EDAP-Launch-June-2021-1200x1200.jpeg 1200w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\" \/><\/a><p id=\"caption-attachment-12592\" class=\"wp-caption-text\">In June of 2021, Rachel Haroz, MD, FAACT, Division Head of Addiction Medicine and Toxicology at Cooper and now Medical Director at the Center for Healing, who also serves as Addiction Medicine Medical Director at Salem Medical Center, spearheaded the Salem Medical Center Emergency Department Addiction Pathways (SMC EDAP) program, and in partnership with Patricia Fortunato, Content Manager at the Center for Healing, created a compendium of prescriber education and patient-facing health communication resources, since iterated for the Cooper University Health Care Emergency Department Addiction Pathways (CUH EDAP) program and Southern New Jersey Medication for Addiction Treatment Center of Excellence (MATCOE) networks. Resources are available at <a href=\"http:\/\/snjmatcoe.org\">snjmatcoe.org<\/a>.<\/p><\/div>\n<p><span style=\"font-weight: 400\">Under the leadership of <\/span><a href=\"http:\/\/cooperhealth.org\/doctors\/rachel-haroz-md\"><span style=\"font-weight: 400\">Rachel Haroz, MD, FAACT<\/span><\/a><span style=\"font-weight: 400\">, Division Head of Addiction Medicine and Toxicology and now Medical Director at the <\/span><a href=\"http:\/\/cooperhealth.org\/recovery\"><span style=\"font-weight: 400\">Center for Healing<\/span><\/a><span style=\"font-weight: 400\">, the ED created protocols for assessment of opioid withdrawal, initiation of buprenorphine MOUD, and linkage to maintenance treatment for patients with OUD. Dr. Haroz also initiated universal screening protocols for substance use disorder (SUD) for all pregnant patients in the Cooper ED, and in partnership with what is now the Center for Healing, created a linkage to wrap-around perinatal SUD treatment via the center&#8217;s Empowering Mothers to Parent and Overcome with Resilience (EMPOWR) program for pregnant and parenting women struggling with substance use or SUD.<\/span><\/p>\n<p><span style=\"font-weight: 400\">As of 2022, the Cooper ED remains a statewide and national academic and clinical leader in acute access to evidence-based addiction medicine. This acute care innovation has extended to the community with field initiation of buprenorphine post-overdose by Cooper Emergency Medical Services (EMS) paramedics under the leadership of <\/span><a href=\"http:\/\/cooperhealth.org\/doctors\/gerard-carroll-md\"><span style=\"font-weight: 400\">Gerard Carroll, MD, FAAEM, EMT\u2013P<\/span><\/a><span style=\"font-weight: 400\">, Medical Director of EMS and Division Head of EMS\/Disaster Medicine. Individuals who are admitted to the ED for opioid overdose continue to have the ability to be inducted on buprenorphine or methadone with referral for follow-up care at any Center for Healing clinical practice location, CAMcare, or Delaware Valley Medical (Pinnacle Treatment Center). Further the center and EDAP have partnered with Advanced Recovery Systems to build and staff <\/span><a href=\"https:\/\/cooperhealth.org\/services\/recovery-village-cherry-hill-cooper\"><span style=\"font-weight: 400\">Recovery Village Cherry Hill at Cooper<\/span><\/a><span style=\"font-weight: 400\"> and increase access to inpatient detox and residential services.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Patients who present to the Cooper ED with alcohol use disorder (AUD) are screened, engaged, and are then offered initiation of anti craving medications in the form of oral or depot naltrexone and gabapentin. These patients are linked to the Center for Healing for longitudinal care. The AUD in the ED pathway was implemented in the Cooper ED in the spring of 2021.<\/span><\/p>\n<p><span style=\"font-weight: 400\">The utilization of methadone to treat opioid withdrawal and initiation of treatment for OUD was also standardized in 2021 in the Cooper ED and by the inpatient consult team. Further, across 2022, the team completed a retrospective evaluation of methadone initiation in the ED with linkage to treatment at Pinnacle Treatment Center, collecting visit attendance data post-hospital discharge. In this study, the team\u2014led by Samantha Huo, MD, recent <\/span><a href=\"http:\/\/cooperhealth.edu\/fellowships\/addiction-medicine\"><span style=\"font-weight: 400\">Cooper Addiction Medicine Fellowship<\/span><\/a><span style=\"font-weight: 400\"> graduate, and overseen by Dr. Haroz\u2014describes the utilization of the <\/span><a href=\"http:\/\/ecfr.gov\/current\/title-21\/chapter-II\/part-1306\/subject-group-ECFR1eb5bb3a23fddd0\/section-1306.07\"><span style=\"font-weight: 400\">Code of Federal Regulations (CFR) Title 21 1306.07 (b)<\/span><\/a><span style=\"font-weight: 400\">, also known as the &#8220;72-hour rule,&#8221; to initiate methadone for OUD in the Cooper ED. The <\/span><a href=\"http:\/\/jem-journal.com\/article\/S0736-4679(23)00010-0\/pdf\"><span style=\"font-weight: 400\">manuscript and accompanying algorithm<\/span><\/a><span style=\"font-weight: 400\"> was accepted for publication and is in press with the <\/span><i><span style=\"font-weight: 400\">Journal of Emergency Medicine<\/span><\/i><span style=\"font-weight: 400\"> as of January of 2023.<\/span><\/p>\n<div id=\"attachment_12593\" style=\"width: 3210px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/blogs.cooperhealth.org\/ehealth\/files\/2023\/03\/SNJMATCOE-EDAP-MMT-Algorithm.png\" rel=\"lightbox[12589]\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-12593\" class=\"size-full wp-image-12593\" src=\"https:\/\/blogs.cooperhealth.org\/ehealth\/files\/2023\/03\/SNJMATCOE-EDAP-MMT-Algorithm.png\" alt=\"Algorithm diagramed in chart.\" width=\"3200\" height=\"2400\" srcset=\"https:\/\/blogs.cooperhealth.org\/ehealth\/files\/2023\/03\/SNJMATCOE-EDAP-MMT-Algorithm.png 3200w, https:\/\/blogs.cooperhealth.org\/ehealth\/files\/2023\/03\/SNJMATCOE-EDAP-MMT-Algorithm-300x225.png 300w, https:\/\/blogs.cooperhealth.org\/ehealth\/files\/2023\/03\/SNJMATCOE-EDAP-MMT-Algorithm-1024x768.png 1024w, https:\/\/blogs.cooperhealth.org\/ehealth\/files\/2023\/03\/SNJMATCOE-EDAP-MMT-Algorithm-768x576.png 768w, https:\/\/blogs.cooperhealth.org\/ehealth\/files\/2023\/03\/SNJMATCOE-EDAP-MMT-Algorithm-1536x1152.png 1536w, https:\/\/blogs.cooperhealth.org\/ehealth\/files\/2023\/03\/SNJMATCOE-EDAP-MMT-Algorithm-2048x1536.png 2048w, https:\/\/blogs.cooperhealth.org\/ehealth\/files\/2023\/03\/SNJMATCOE-EDAP-MMT-Algorithm-1200x900.png 1200w\" sizes=\"auto, (max-width: 3200px) 100vw, 3200px\" \/><\/a><p id=\"caption-attachment-12593\" class=\"wp-caption-text\">View the algorithm at <a href=\"http:\/\/cooperhealth.edu\/fellowships\/addiction-medicine\/quality\">cooperhealth.edu\/fellowships\/addiction-medicine\/quality<\/a>.<\/p><\/div>\n<h2><b>Emergency Medical Services Treatment Pathways<\/b><\/h2>\n<p><span style=\"font-weight: 400\">Since 2019, Cooper&#8217;s <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/32208945\/\"><span style=\"font-weight: 400\">Buprenorphine Field Initiation of ReScue Treatment (Bupe FIRST EMS)<\/span><\/a><span style=\"font-weight: 400\">, as the program is now known, was the first program nationally, and remains the only EMS agency in the state, to provide buprenorphine MOUD in the field. Cooper EMS, Addiction Medicine, and Toxicology Divisions collaborated to write <\/span><a href=\"https:\/\/www.snjmatcoe.org\/_files\/ugd\/6ee35c_738ea91a1e2648c4b6819d4cefbb8736.pdf\"><span style=\"font-weight: 400\">a protocol<\/span><\/a><span style=\"font-weight: 400\"> for buprenorphine administration in the field, well-received and proliferated across the nation. Investigators, led by Dr. Carroll and overseen by Dr. Haroz, published a case series to describe the intervention and most recently, in September of 2022, published <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/36192278\/\"><span style=\"font-weight: 400\">a retrospective cohort study<\/span><\/a><span style=\"font-weight: 400\"> in <\/span><i><span style=\"font-weight: 400\">Annals of Emergency Medicine<\/span><\/i><span style=\"font-weight: 400\"> to determine the impact of this program on subsequent overdose and treatment retention, in collaboration with researchers from the Johns Hopkins Bloomberg School of Public Health. Additionally, investigators have presented the protocol at <\/span><a href=\"http:\/\/njopioidsummit2022.vfairs.com\"><span style=\"font-weight: 400\">regional<\/span><\/a><span style=\"font-weight: 400\"> and <\/span><a href=\"http:\/\/nida.nih.gov\/news-events\/meetings-events\/2022\/09\/prehospital-treatment-opioid-use-disorder\"><span style=\"font-weight: 400\">national<\/span><\/a><span style=\"font-weight: 400\"> conferences, and the protocol has since been adapted by EMS across the nation and gained recognition in <\/span><a href=\"https:\/\/www.medpagetoday.com\/opinion\/second-opinions\/100766\"><span style=\"font-weight: 400\">various press<\/span><\/a><span style=\"font-weight: 400\">.<\/span><\/p>\n<h2><b>Addiction Consultation Services Team<\/b><\/h2>\n<p><span style=\"font-weight: 400\">Since its inception, the Cooper Addiction Medicine team, now known as the Center for Healing team, has offered expert-level addiction care for patients with complex medical needs who are hospitalized at Cooper. Over time, the need and request for hospital consults grew, and in 2017, the Division of Addiction Medicine piloted a full-time consult service, now known as the CUH ACT (Cooper University Health Care Addiction Consultation Services Team). The ACT is now fully staffed with addiction medicine board-certified physicians, addiction medicine fellows, advanced practice providers, a clinical alcohol and drug counselor who also serves as inpatient care coordination supervisor, and behavioral medicine psychologists. The ACT is a teaching service run by <\/span><a href=\"http:\/\/cooperhealth.org\/doctors\/matthew-salzman-md\"><span style=\"font-weight: 400\">Matthew Salzman, MD<\/span><\/a><span style=\"font-weight: 400\">, Medical Director of Inpatient Consult Services for Addiction Medicine and Medical Director of Research at the Center for Healing.<\/span><\/p>\n<p><span style=\"font-weight: 400\">The center&#8217;s physicians are also working with other hospital divisions on quality improvement (QI) projects and protocols for treating common illnesses. The center is training more hospitalist providers in basic addiction medicine care, and as an organization, the team is working to ensure that all hospital medicine providers offer MOUD to OUD patients. As this training has increased, the number of buprenorphine prescriptions written by non-addiction medicine providers have also increased, enabling MOUD as part of routine care.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Most recently, in January of 2023, as part of a content and clinical collaboration and overseen by Dr. Salzman, the center produced a new inpatient clinician education tool for inpatient nurses\u2014a screening, brief intervention, and referral to treatment (SBIRT) algorithm for inpatient settings, since iterated for the team&#8217;s Southern New Jersey MATCOE networks.<\/span><\/p>\n<div id=\"attachment_12591\" style=\"width: 3210px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/blogs.cooperhealth.org\/ehealth\/files\/2023\/03\/SNJMATCOE-Inpatient-Clinician-Education-SBIRT-Algorithm.png\" rel=\"lightbox[12589]\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-12591\" class=\"size-full wp-image-12591\" src=\"https:\/\/blogs.cooperhealth.org\/ehealth\/files\/2023\/03\/SNJMATCOE-Inpatient-Clinician-Education-SBIRT-Algorithm.png\" alt=\"Algorithm documented in a chart.\" width=\"3200\" height=\"2400\" srcset=\"https:\/\/blogs.cooperhealth.org\/ehealth\/files\/2023\/03\/SNJMATCOE-Inpatient-Clinician-Education-SBIRT-Algorithm.png 3200w, https:\/\/blogs.cooperhealth.org\/ehealth\/files\/2023\/03\/SNJMATCOE-Inpatient-Clinician-Education-SBIRT-Algorithm-300x225.png 300w, https:\/\/blogs.cooperhealth.org\/ehealth\/files\/2023\/03\/SNJMATCOE-Inpatient-Clinician-Education-SBIRT-Algorithm-1024x768.png 1024w, https:\/\/blogs.cooperhealth.org\/ehealth\/files\/2023\/03\/SNJMATCOE-Inpatient-Clinician-Education-SBIRT-Algorithm-768x576.png 768w, https:\/\/blogs.cooperhealth.org\/ehealth\/files\/2023\/03\/SNJMATCOE-Inpatient-Clinician-Education-SBIRT-Algorithm-1536x1152.png 1536w, https:\/\/blogs.cooperhealth.org\/ehealth\/files\/2023\/03\/SNJMATCOE-Inpatient-Clinician-Education-SBIRT-Algorithm-2048x1536.png 2048w, https:\/\/blogs.cooperhealth.org\/ehealth\/files\/2023\/03\/SNJMATCOE-Inpatient-Clinician-Education-SBIRT-Algorithm-1200x900.png 1200w\" sizes=\"auto, (max-width: 3200px) 100vw, 3200px\" \/><\/a><p id=\"caption-attachment-12591\" class=\"wp-caption-text\">Prescriber and clinician education and health communication resources are available at <a href=\"http:\/\/snjmatcoe.org\">snjmatcoe.org<\/a>.<\/p><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Yesterday was the last day of National Drug and Alcohol Facts Week\u00ae (NDAFW), an observance that encourages dialogue surrounding substance use and substance use disorder (SUD). As part of NDAFW, the Cooper University Health Care Center for Healing, a State of New Jersey-designated Medication for Addiction Treatment Center of Excellence (MATCOE), shared content on the &#8230; <span class=\"more\"><a class=\"more-link\" href=\"https:\/\/blogs.cooperhealth.org\/ehealth\/2023\/03\/27\/ndafw-emergency-medicine-and-hospital-based-addiction-care-available-at-cooper\/\">[Read more&#8230;]<\/a><\/span><\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":{"0":"entry","1":"post","2":"publish","3":"author-rmineo","4":"post-12589","6":"format-standard","7":"category-uncategorized"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>#NDAFW: Emergency Medicine and Hospital-Based Addiction Care Available at Cooper - eHealth Connection<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.cooperhealth.org\/ehealth\/2023\/03\/27\/ndafw-emergency-medicine-and-hospital-based-addiction-care-available-at-cooper\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"#NDAFW: Emergency Medicine and Hospital-Based Addiction Care Available at Cooper - eHealth Connection\" \/>\n<meta property=\"og:description\" content=\"Yesterday was the last day of National Drug and Alcohol Facts Week\u00ae (NDAFW), an observance that encourages dialogue surrounding substance use and substance use disorder (SUD). As part of NDAFW, the Cooper University Health Care Center for Healing, a State of New Jersey-designated Medication for Addiction Treatment Center of Excellence (MATCOE), shared content on the ... 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