Opioid Use Disorder in Emergency Departments

Every Wednesday, 12:00-1:00 PM

Opioid use in rural areas has reached epidemic proportions in the United States. Outbreaks of HIV and HCV are associated with syringe sharing among partners injecting prescription opioids in rural Indiana, and increases in heroin and fentanyl-related drug overdose deaths have been reported throughout the Midwest. Illinois ranked as the third highest state in percentage increase in death rates involving synthetic opiates between 2014-2015. Rural areas in southern Illinois may be disproportionately affected by the epidemic. The southernmost 16 counties in Illinois are part of the federally designated Delta Regional Authority (Illinois Delta Region; IDR), an area of 252 counties and parishes described as the most economically distressed area of the country. This area has been adversely affected by loss of coal mining and agricultural employment, population decline, and defunding of public services, and is both geographically proximate to and shares many of the demographic characteristics as Scott County, IN.

Survey respondents for the “Ending transmission of HIV, HCV, and STDs and overdose in rural communities of people who inject drugs (ETHIC)” study (NIDA UG3 DA044829-02) reported frequent use of the Emergency Department (ED) as their primary source of healthcare. Additionally, our qualitative data revealed many breaches of trust by ED providers, such as disclosures of protected health information to law enforcement and child protective services, as well as stigmatizing and humiliating provider-patient interactions. These experiences and perspectives were substantiated by commentary from healthcare providers whom we interviewed. This ECHO series will address these known challenges and gaps in care, to help ED staff implement and sustain evidence-based, patient-centered practices by providing practical knowledge and skills for managing and communicating with patients that have opioid use disorder.

Topics for Case-Based Learning and Discussion Include:

• Role of ED in the opioid epidemic
• Prescribing guidelines and prescription monitoring programs
• Methamphetamines
• Opioids and Infectious Disease
• Medications for Opioid Use Disorder (MOUD or MAT)
• Take-home naloxone
• Non-opioid pain control
• Legal issues and communication skills