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Expanded addiction treatment offered in SIUH, RUMC emergency departments

STATEN ISLAND, N.Y. -- Staten Island University Hospital (SIUH) and Richmond University Medical Center (RUMC) are now offering buprenorphine in its emergency departments to help patients suffering from substance misuse disorders get on the road to recovery.

Commonly used for Medication-Assisted Treatment (MAT) for addiction, buprenorphine is a medication that eases withdrawal symptoms and minimizes the craving for opioids.

SIUH and RUMC are two of six emergency departments that are now offering this treatment, the city Department of Health announced.

Between Jan. 1 and Aug. 20 there have been 71 fatal overdoses and 171 "saves" using naloxone, according to a spokesman for District Attorney Michael E. McMahon's office. 

During the same time last year, there were 70 fatal overdoses and 128 naloxone saves, according to Advance records.

"Often, a visit to the emergency department is just the moment when a patient is finally ready to consider medication-assisted therapy...," said Dr. Mitchell Katz, president and CEO at NYC Health and Hospitals.

"Our public health system recognizes the importance of being able to offer a range of treatment options in a range of venues," Katz said.

Dr. Nicole Berwald, interim chair of SIUH's emergency department, has been working at SIUH for over 10 years and is excited about being able to treat patients in a way she wasn't able too before.

"People get motivated and in that moment they want help. This allows us to help them immediately before they change their mind," Berwald said.

Patients who find themselves in the emergency department -- whether by choice or as a result of a non-fatal overdose -- will be assessed to see if they meet qualifications for active withdrawal. Should they qualify, they will be given buprenorphine and connected to the clinic for follow-up treatment.

If an individual doesn't qualify for buprenorphine, they are still connected to SIUH's clinic for outpatient services.

Giving buprenorphine to an individual who isn't in active withdrawal can make them sick, Berwald explained, and will not have the proper effects.

"This is real medication that treats the underlying problem. Being on buprenorphine makes patients feel much better and motivates them to continue with treatment," she said. 

SIUH began offering MAT in the emergency department in July.

Berwald said that while it's still early, the response from patients and providers has been positive so far

"It's all about changing mindsets about how we take care of patients with substance misuse disorders. We don't want people do die," she said.

A spokesman for RUMC said it began offering the life-saving medication in its emergency department in the beginning of the year.

"RUMC has long been a leader in implementing effective integrated behavioral medicine protocols to provide comprehensive mental health and substance use disorder treatment. By offering buprenorphine treatment in our emergency department, we are providing immediate help for people with opioid addiction," said Daniel Messina, president and CEO of RUMC.

Last month Staten Island's new public health care center announced its participation in the Buprenorphine Nurse Care Manager Initiative.

The NYC Health and Hospitals/Gotham Health Vanderbilt clinic, located at 165 Vanderbilt Ave. in Clifton, is the first full-service public health care clinic on Staten Island.

Through the initiative, nurse case managers will screen and assess patients for treatment; manage MAT dosages and track progress, and refer patients to supportive services, such as housing and food benefits.

Since the initiative's launch in 2017, nearly 350 patients citywide have received treatment. The initiative's expansion allows for the treatment of over 5,000 patients.