Lessons From Northwell Health: How a Hospital System is Responding to the Opioid Epidemic
Since 1999, the number of overdose deaths involving opioids, including prescription opioid pain relievers and heroin, has nearly quadrupled. In September, for the first time, the White House designated a Prescription Opioid and Heroin Epidemic Awareness Week. As part of this awareness week, President Obama called for expanding access to prevention and treatment services for opioid use disorders.
One strategy for preventing opioid overdose deaths is use of the medication naloxone. Naloxone is administered by injection or nasal spray, and can block the effects of opioids and reverse overdoses. First responders and doctors have used it for years. In the midst of our country’s opioid crisis, non-medical professionals – including people at-risk for opioid overdoses and their friends and family – are being encouraged to carry naloxone and to know how to use it.
While this is a positive step forward, there are barriers to friends and family members accessing this lifesaving medication. One barrier is that insurance companies frequently don’t cover the medication for the person at-risk, and are even less likely to approve coverage for a friend or family member. Another barrier is that hospitals and other health care providers are sometimes unprepared to teach individuals how to use naloxone, or even have the medication in supply.
Leading By Example
In collaboration with the New York State and local Departments of Health, Northwell Health, one of the largest health care providers in the country, is working on an initiative to address the problem of naloxone access head on. The program, called the Naloxone Saturation Campaign, is currently being implemented in Northwell Health emergency departments with plans to expand to primary care and hospital inpatient settings.
The Naloxone Saturation Campaign builds on an existing large-scale initiative that Center on Addiction helped develop along with Northwell Health’s departments of psychiatry, emergency medicine and internal medicine, called Screening Brief Intervention and Referral to Treatment, or SBIRT. The Naloxone Saturation Campaign aims to build on SBIRT by increasing access to naloxone, reducing overdose, and facilitating access to treatment for patients who receive SBIRT services.
The new opioid overdose reversal project is being piloted in several Northwell Health emergency departments in New York State, in counties with the highest overdose rates. Yet this increased access to naloxone is not just for those who are misusing opioids, but their families and friends can now be trained on how to intervene to rescue their loved one.
Dr. Sandeep Kapoor, Northwell Health’s SBIRT Director, said “by providing family and friends with training and the naloxone rescue kit, we are empowering them with enhanced knowledge and a tangible tool to save the lives of their loved ones and community members.”
More People are Being Helped
The Naloxone Saturation Campaign started at Northwell Health’s Staten Island University Hospital and based on its success, it has been expanded. For example, at one hospital in New York, within just 40 days, 86 naloxone kits were distributed to at-risk patients, their families, and health care staff who wanted to be prepared in the event of an overdose. These individuals were then trained by hospital staff on how to use the kits and given one that day. The life-saving effects of this program could be immediate.
There’s More to be Done
As an addiction psychologist and researcher in the field, I know that states, health care organizations, families and patients need innovations to decrease overdoses and increase treatment options. I’ve seen firsthand how this life-saving project is providing a successful and innovative framework for other health care organizations and communities to follow. Our embedding naloxone distribution and training within an SBIRT framework addresses one of the major criticisms of naloxone – which is that it needs to be paired much more strongly with efforts to promote access to ongoing treatment. Thus, with increased access to naloxone and efforts to refer to treatment, we’re not merely saving lives, but creating the opportunity for individuals with addiction to get the treatment they deserve and need to recover.
Megan O'Grady, PhD
Dr. O'Grady is a Research Scientist at Center on Addiction