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Meritus Health's crisis stabilization bed program for substance use abusers has been so successful in its first five months, the executive director of Meritus Behavioral and Community Health said there's no plan to discontinue the pilot program at this time.
"I think it's beyond a pilot in that we're committed to helping with this population and the success rate (linking these patients) to treatment proves it is a successful program," Allen Twigg said recently.
Meritus Medical Center started the three-bed program for ages 18 and older in its Emergency Department at the end of August.
The crisis stabilization beds program is driven by the opioid epidemic that has cost hundreds of local lives with many people experiencing overdoses in recent years.
From 2011 through 2020, 535 people died in Washington County from opioid-related intoxication, according to the Maryland Department of Health's 2020 annual report for Unintentional Drug- and Alcohol-Related Intoxication Deaths. Opioids in this stat include heroin and prescription opioids such as oxycodone, hydrocodone, hydromorphone, methadone, tramadol and codeine, and prescribed and illicit fentanyl, the report states.
Another step Meritus has taken in recent years is working with local health providers to reduce the prescribing of opioids, said Carrie Adams, the hospital's chief operating officer.
Since that initiative began about two years ago, the equivalent of 4.4 million tablets of Vicodin have not made their way into the community and its medicine cabinets, Adams said.
Prescription opioids are often a trigger to addiction that can lead to the use of illegal opioids like heroin, with heroin often being laced with synthetic fentanyl, local harm-reduction officials have said.
While federal funding has been sought for the crisis stabilization beds at the hospital, the program is completely funded by Meritus at this time with nearly $400,000 a year, Meritus officials said.
Meritus officials are hoping the hospital will be considered for state or federal funds so the program can be extended beyond three beds, Adams said.
Twigg said opioids have been the primary substance of use for patients who have used the crisis stabilization beds so far.
The beds are not just for those brought into the Emergency Department with overdoses, Twigg said. There have been patients with opioid addictions who have referred themselves, or family members who brought patients in for evaluation.
"They might not meet the acute criteria for hospitalization, but they want help and we want to enable them to get help they need," Twigg said.
Thirty-six people have used the beds as of Jan. 31. More than 85% of patients served by the crisis beds have been connected with treatment, with more than half going to an inpatient treatment program, he said.
Meritus officials evaluate crisis stabilization patients and develop a plan of care for them that might, if needed, include administering buprenorphine, he said.
Buprenorphine, taken as prescribed, helps diminish withdrawal symptoms and cravings, according to the federal Substance Abuse and Mental Health Services Administration.
It can be difficult to get a person directly into an inpatient treatment bed from the Emergency Department, but Meritus has had "excellent success making it happen within two to three days," Twigg said. There's a huge demand for treatment in Maryland so sometimes it takes a few days to get someone a treatment bed elsewhere, he said.
Meritus is "not going to discharge someone after three days because (we) don't have a plan for them," he said.
While the number of treatment beds in Washington County has increased, Meritus has referred people to more than 80 miles away, Twigg said. Many providers with an available bed will help with transportation.
"I believe every intervention is an opportunity," Twigg said. Even if a patient has been seen 10 times before, "today might be the day" when that person is willing to get help, he said.
Increasing access to treatment is among the evidence-based, data-driven proposals listed in the U.S. Commission on Combating Synthetic Opioid Trafficking's final report, released on Tuesday, according to a news release from Congressman David Trone's office. Trone, D-6th District, co-chaired the commission.
More:Opioid settlement: What does it mean for Washington County and Hagerstown?
More:Adolescents and young adults lost more than 1.25M years of life to drug overdose deaths in a 4-year period, study finds
More:A doctor wrote over 20,000 prescriptions for opioids, prosecutors say. Five people died.
More:Amatus' counseling center in Funkstown could open by mid-January
Washington County and Hagerstown are among the governments in Maryland that have signed on to an agreement for distributing money from an opioids lawsuit settlement involving Johnson & Johnson and distributors McKesson, AmerisourceBergen and Cardinal Health.
The two local governments are among the municipalities and counties who, a few years ago, sued drug makers and distributors over the opioid epidemic's fallout.
The companies have said the settlement was not an admission of liability or wrongdoing.
On the local front, Adams said Meritus has been working with health providers within Meritus' organization as well as those with which it interacts to reduce the prescribing of opioids. That includes primary doctors, emergency department doctors and surgeons who aren't employed by Meritus, she said.
The prescription initiative has three priorities, Adams said. They are to make sure providers understand how much and what type of drugs they are prescribing; collaborating and agreeing on standard procedures such as prescription order sets; and focusing on patient-centered care, she said.
Prescribers can't just give patients a 90-day supply of pain meds, Adams said.
As an example, Adams mentioned a patient who goes to the Emergency Department for a toothache. That patient might be given enough pain meds, maybe three days' worth, to cover the time before getting in to see a dentist.
The new initiative also is about exhausting alternative therapies like physical therapy for pain management and helping patients adjust their expectations, Adams said.
"Sometimes pain management isn't zero pain. It's tolerable pain," she said.
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