Scripps Mercy is one of 31 health facilities in the state to receive grant funding for the California Bridge Program, which is managed by the Oakland-based Public Health Institute. The program is funded through the California Department of Health Care Services and Substance Abuse and Mental Health Services Administration.
“The goals of the California Bridge Program align very nicely with our commitment at Scripps to help reduce opioid overuse and dependence,” said Valerie Norton, M.D., emergency medicine physician and physician operations executive at Scripps Mercy San Diego. “This program will treat a hospital visit as a critical window for starting opioid addiction treatment.”
Scripps Mercy will receive funding, training and technical assistance to create a two-pronged program, which will begin in its emergency department for patients identified as needing and willing to receive treatment for an opioid use disorder.
First, emergency room doctors will receive training and the necessary Drug Enforcement Administration clearance to administer a dose of medication such as buprenorphine during the patient’s ER visit to ease severe symptoms of withdrawal. Patients may also receive a prescription for medication as a “bridge” until they connect with ongoing care.
Second, Scripps Mercy’s emergency department will add treatment counseling support to work directly with patients before discharge to help connect them with ongoing care at Scripps’ outpatient clinic partner, Family Health Centers of San Diego. Scripps also will provide follow-up monitoring of patients’ outpatient care. Cara Bergamo, M.D., an emergency physician at Scripps Mercy, will be the physician champion for the grant project.
Creating a bridge
“By suppressing withdrawal long enough to create a bridge for patients to enter and remain in treatment, physicians can save lives,” said Andrew Herring, M.D., director of emergency department services for the California Bridge Program. “We know this model works and now we are bringing it to hospitals across the state.”
Ongoing efforts at Scripps
The new California Bridge Program will work in concert with a separate initiative launched by Scripps in 2017, the Opioid Stewardship Program (OSP).
The OSP has spearheaded multiple projects at Scripps to educate patients and providers about the risks of opioids and the benefits of alternative multi-modal pain management options to reduce opioid use. The program has established prescribing standards for opioids, resulting in a 25 percent reduction in the number of opioid pills per prescription at Scripps hospitals and outpatient centers in 2018. Scripps also has opened three drug take-back kiosks at its on-site pharmacies, offering patients year-round access to dispose of unused, unneeded or outdated medications.
“The California Bridge Program is an important opportunity for Scripps Mercy and other hospitals statewide to take a new approach to help those with opioid use disorders receive much-needed treatment,” said Ole Snyder, M.D., OSP co-chair.
Scripps’ grant application for the California Bridge Program was aided by its OSP team, including Dr. Snyder; Angela Rosenblatt, OSP co-chair and Scripps Health director of pharmacy clinical services; and OSP members Harminder Sikand, director of clinical services at Scripps Mercy San Diego; Roneet Lev, M.D.; and Dr. Norton.