Kootenay Boundary Regional Hospital emergency department nurses: Jane Carlton, Tamara Roscoe, Teresa Myers, and Emily Larochelle.
Interior Health is making the opioid use disorder medication Suboxone widely available in its hospital emergency departments.
Opioid use disorder (OUD) is a treatable medical condition. And, yet, many people living with OUD don’t have a regular care provider who can help connect them to medication. For many, their first exposure to treatment is through an emergency department (ED).
Given the increasing number of toxic drug deaths across B.C. – 2,224 in 2021* – Interior Health’s Emergency Services and Mental Health and Substance Use networks partnered in June 2021 to connect people experiencing opioid use disorder with Suboxone in emergency departments. Suboxone is an Opioid Agonist Treatment (OAT) medication used to treat OUD.
The project includes offering Suboxone “to-go packs” to start patients at home and a new urgent referral process to connect people to ongoing OAT in the community.
“The toxic drug crisis continues to impact patients, families, and communities. We can be part of the solution to this ongoing public health emergency and hopefully prevent lives from being lost by providing OAT in the ED,” says Heather Hair, Interior Health emergency services network director. “Frontline health-care workers in emergency departments often see first-hand the impacts of addiction and toxic drug deaths. We are having conversations and building relationships with people who often have experienced stigma, and hopefully helping keep them from harm.”
The Suboxone in the ED project has now been implemented at 20 hospitals across Interior Health, most recently in the South Okanagan in April, which resulted in a celebration of the enrolment of the 100th client in the program. In May, Suboxone in the ED is being introduced in hospitals throughout the Kootenay Boundary. All sites will be included by September 2022.
Having Suboxone available in EDs has decreased barriers to accessing OAT in communities by providing front-line nurses and physicians with the necessary training to prescribe the treatment, and by helping educate patients on how to start it themselves at home.
Feedback from both clinicians and patients has been overwhelmingly positive.
Nurse Prescriber Laura Sherret, who works in Cranbrook, says when she first heard about the plan to implement Suboxone in the ED at East Kootenay Regional Hospital, she was excited – especially because access to OAT was otherwise fairly limited in the community. Since then, the program has surpassed her expectations.
“The clients I have seen as a Nurse Prescriber who have succeeded in staying on Suboxone or transitioned to the long-acting injectable are doing very well,” says Laura. “They are reconnected to families, have jobs, and are managing life’s challenges in positive ways. Others have gone on to other OAT therapies that suit them better so they, too, can move forward. We continue to build relationships and trust with people and support them in their choices.”
Laura also says she has seen an “amazing shift” in the ED staff she works with, because they have a better understanding of what Suboxone is and how it works.
“They have a resource at their fingertips to help patients with opioid use disorder,” she says. “They can initiate Suboxone in the ED if the person is in sufficient withdrawal, or discharge the person with a To-Go Pack to start at home. The relative safety of Suboxone and its ability to relieve withdrawal symptoms quickly makes it a good option for people who live with opioid use disorder.
“It is now considered the gold standard of care, and that care is being provided right here in the ED at East Kootenay Regional Hospital.”
Check out the video about Suboxone in the ED.
To learn more about OAT visit interiorhealth.ca.
*BC Coroner's Service Drug Toxicity Report Feb. 2022