UNDERSTANDING THE TOXIC CYCLE: EXPANDING EMERGENCY CARE OF ALCOHOL & OTHER DRUGS

The ED is frequently the only source of care for patients with substance abuse and dependency problems.  We are using the SEM framework to understand how the ED can improve the care of these patients, particularly with referral to treatment, brief interventions, and clinical strategies for patients in acute withdrawal. 


ED-BRIDGE: EMERGENCY BUPRENORPHINE TREATMENT IN EMERGENCY DEPARTMENTS 

Site PI: Andrew Herring, MD

Funder: Substance Abuse and Mental Health Services Administration (SAMHSA) and the State Targeted Response to the Opioid Crisis Grant to the California Department of Health Care Services (DHCS)

Dr. Herring was recently awarded a grant through the Substance Abuse and Mental Health Services Administration (SAMHSA) State Targeted Response to the Opioid Crisis Grant to the California Department of Health Care Services (DHCS) to create the ED-BRIDGE program. 

The purpose of the grant is to address the opioid crisis by improving access to treatment, reducing unmet treatment need, and reducing opioid overdose related deaths through the provision of prevention, treatment, and recovery activities for OUD. The California MAT Expansion Project is implementing the California Hub and Spoke System (CA H&SS).  Each CA H&SS consists of a “Hub” and multiple “Spokes”.  An existing Narcotic Treatment Program (NTP) or Medication Unit will serve as the Hub while federally approved Data 2000 waivered prescribers who prescribe or dispense buprenorphine in office-based settings will serve as the Spokes. This grant implements the integration of EDs as active partners in the expansion of MAT in California.

ED-BRIDGE supports emergency departments throughout California to develop and implement plans for 24/7 access to buprenorphine for patients with opioid use disorder.

Visit the ED-Bridge website here:  https://ed-bridge.org/

Read more about Dr. Herring's work here: http://www.oaklandmagazine.com/October-2017/Facing-the-Opioid-Emergency/


MEDICATION ASSISTED TREATMENT oF OPIOID ADDICTION IN tHE EMERGENCY DEPARTMENT

Site PI: Andrew Herring, MD

Funder: California HealthCare Foundation

The objective of this project is to increase access to medically assisted treatment of opioid addiction through initiating treatment in the emergency department. The project will pilot a treatment model, proven successful in a controlled academic environment, in an urban region, and share the results in CHCF and peer-reviewed publications.


ENVIRONMENTAL DRINKING CONTEXTS & INTIMATE PARTNER VIOLENCE

Site PI: Harrison Alter, MD, MS

Funder: NIH 1R01AA022990

The relationship between alcohol use and intimate partner violence is well-established but little understood. To help move the field forward, the Levitt Center has partnered as a subawardee with the Pacific Institute for Research and Evaluation to perform a mixed-methods study of drinking contexts -- where, when and with whom -- and how such contexts influence partner abuse patterns. This is a five year project, and will involve in-depth interviews of dozens of patients and surveys of hundreds.


THE PHARMACO-ECOLOGY OF GUN VIOLENCE: A Pilot Investigation

Site PI: Harrison Alter, MD, MS

Funder: The Pacific Institute for Research and Evaluation (PIRE)

It is a truism that guns and drugs don't mix, but in certain social settings they appear to be inextricable. This small exploratory study, in collaboration with toxicologists and emergency physicians at the University of California, Fresno and anthropologists at aims to understand the interplay between the substances that gun-injured patients believe they use and why, as well as what is actually in their bloodstream at the time of their injury.