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With visits related to substance use disorders projected to be near 1,000 for the emergency department by mid-2022, Meritus Health began a pilot project in late August, offering crisis stabilization beds at the hospital. Until now, this kind of accommodation did not exist in Washington County.

The initial three crisis beds, which allow willing overdose patients to stay for 24-48 hours at the hospital for evaluation and monitoring, have helped 36 patients as of the end of January – with more than 85% of them connected to treatment programs following their stay.

“We are committed to helping this population and the success rate linking crisis stabilization bed patients to treatment proves our program is working,” said Allen Twigg, executive director of Meritus Behavioral and Community Health. “Every one of these interventions is an opportunity, because even if we have seen a patient come through the emergency department many times before, today might be the day when they are willing to get help.”

The space allows hospital staff to provide supportive counseling and evaluation of patients, initial stabilizing and monitoring and development of the individual’s care recovery plan to better determine the inpatient and outpatient programs and services that are the right fit for their needs.

In the past four months, the hospital’s emergency department (ED) has seen trends that could lead to a 10% overall increase from last year in patients needing crisis services, including substance use and mental health. The largest jump comes among pediatric patients – ages 18 and younger – who jump from 21% of those with crisis needs in prior years to 30% of the total coming through the ED this year.

“It can be difficult to get a patient directly into an inpatient treatment bed, and while we have had great success making it happen within a two-to-three day window, we are not going to discharge someone after a few days without a plan for treatment,” said Twigg. “Some of these patients may not meet the immediate need for hospitalization, but they want help and we want to enable them to get the help they need.”

Meritus Health has sought federal, state and grant funding for the crisis stabilization beds, but so far, the program is completely funded by the health system with nearly $400,000 a year.

The health system has been working in multiple areas to actively address substance abuse disorders for years. On the front end of the addiction cycle, an initiative with local health care providers to reduce the prescribing of opioids has reduced the equivalent of 4.4 million tablets of Vicodin from our community. The overuse or abuse of prescription opioids can often lead to the use of illegal opioids like heroin or fentanyl.

“The priorities are to make sure providers understand dosage and type of drugs they are prescribing, collaborating on standard procedures and focusing on patient-centered care,” said Carrie Adams, chief operating officer for Meritus Health. “It’s important that pain management efforts like physical therapy are exhausted and it’s very important that the expectations of patients are discussed and adjusted, knowing that sometimes tolerable pain is the goal, rather than zero pain and a potential addiction.”