espite growing efforts in health care to combat substance misuse, reports show that drug-related fatalities are still rising. Numerous movements aimed at getting patients who are struggling with substance use disorders the treatments they need have swept the country, but few have found substantial footing.

While ambulatory services for substance use exist nationwide, the concept of “bridge programs” where people can seek inpatient and outpatient care for substance use disorders, has only recently gained traction. In the past, patients who were admitted for use disorders encountered obstacles to continued care once they were discharged. They were simply handed a phone number and told, “Good luck.”

Seamless inpatient and outpatient substance use support

Here at the U of U Health, we’ve implemented a different approach to substance use care. We’ve created a warm transition system where patients could leave with medication in hand and a follow-up appointment on the books.

We built upon the work of Dr. Beth Howell, the Training Director for the Addiction Psychiatry and Addiction Medicine fellowship programs at the U of U School of Medicine, whose battle to overcome the stigmatization and silencing of substance use in health care has paved the way for more open discussions.

With the support of federal grants, the Huntsman Mental Health Institute (HMHI) Bridge Program has flourished. The Emergency Departments at University of Utah Hospital and South Jordan Health Center, in collaboration with the Department of Psychiatry, have created a program that provides continued access to opioid and drug addiction treatments. Through our Inpatient Addiction Consult Service and the HMHI Bridge Program, we’re working to create a seamless transition between inpatient and outpatient support.

Because of the support we’ve received from other departments within the hospital network, we have successfully become the only health care institute to provide inpatient and ambulatory substance use services in the state of Utah.

Substance use is a medical problem—it requires a specialized approach

We attribute our success largely to our multidisciplinary team of experts. We are a full-fledged service of about half a dozen different faculty members who specialize in addiction medicine and addiction psychiatry. Our staff also includes addiction fellows, residents, medical students, and social workers.

Our wonderful social workers are dedicated solely to helping patients with substance use disorders. They help us navigate the ins and outs of insurance and provide patients with essential resources and information on community programs once they leave the hospital.

How to connect with our team

For inpatient assistance, you can contact us in the following ways:

• Page us through Epic: Please page us directly with questions AND place a SmartWeb “Addiction Consult” order in Epic. We like to be involved early in the patient's course so that we can help you track important information and coordinate your patient’s follow-up care or treatment.
• Contact our receiving center: At Huntsman Mental Health Institute, we have a receiving center where people can get care for up to 23 hours. They will be assessed for medications or referrals to community organizations, and we can easily help them find inpatient treatment if necessary.

HMHI also provides fully medically supervised withdrawal treatment for alcohol, benzodiazepines, opiates, and anything else that they may need.

For outpatient addiction referrals, we recommend these three resources:

• HMHI Bridge Program: Through this program, patients (regardless of insurance) can begin buprenorphineBuprenorphine is FDA-approved for acute pain, chronic pain, and opioid dependence. It is an agent used in agonist substitution treatment, which is a process for treating addiction by using a substance (such as buprenorphine or methadone) to substitute for a stronger full agonist opioid (such as heroin treatment in the Emergency Department 24/7 and receive weekly follow-up care for the next month. They will meet with a case manager and a prescriber who will continue their assessment and link them to long-term community care that works with their insurance.
• Recovery Clinic: Our recovery clinic is a great place to turn for outpatient treatment of substance use disorders. We provide both psychotherapy and medical treatments for our patients.
• E-Consult: You can contact our e-consult service at any time. Although this new service is currently limited to our outpatient primary care colleagues, this invaluable resource is staffed by qualified fellows who ensure cases are approved by their attending physicians.

What services do we provide?

We work with our social workers, case managers and other departments to treat any patient with a substance use disorder, whether they struggle with opioids, benzodiazepines, alcohol, methamphetamines, or other addictive drugs.

Our goal is to take care of not just their medical issues, but also their substance use issues that contributed to their medical problems.

We offer a broad spectrum of inpatient services, including:

• Detoxification treatments
• Psychiatric support
• Medication management
• Customized discharge plans

We also provide a range of ambulatory services, including:

• Ongoing treatments through the HMHI Bridge Program
• Outpatient psychotherapy
• Follow-up clinic visits with highly trained specialists
• Connections to community resources

We intervene early to keep patients safe

In the past, we’ve witnessed huge barriers to accessible treatments for substance use disorders. Many people—physicians and patients alike—mistakenly consider drug addiction to be primarily a moral issue instead of a medical condition. But drug addiction is a medical problem, and like any other health condition, it requires its own specialized approach.

Now that the X-Waiver is no longer required, we have an entire army of physicians who have the power to make a positive difference by prescribing buprenorphine, but don’t know how to get started. We must incorporate training and help the next generation get comfortable prescribing these lifesaving medications in inpatient and outpatient settings.

There's a societal belief that people suffering from substance use will never recover, and that’s simply not true. We see those battling drug addiction as people first. They are struggling with a problem that is treatable—that they can recover from—and that doesn't make them less than anyone else.

We must do everything we can to reduce stigma for these folks.

Overall, we want providers to remember that you’re not alone. We’re here to help. We’re available to any inpatient team at the University Hospital, Huntsman Cancer Institute, and the Neilsen Rehabilitation Hospital, and we can connect you with resources in the community. Our mission is to intervene early and keep your patients safe.