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Implementation of a Medication for Addiction Treatment (MAT) and Linkage Program by Leveraging Community Partnerships and Medical Toxicology Expertise

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Abstract

Introduction

Implementing a hospital medication for addiction treatment (MAT) and a linkage program can improve care for patients with substance use disorder (SUD); however, lack of hospital funding and brick and mortar SUD resources are potential barriers to feasibility.

Methods

This study assesses the feasibility of implementation of a SUD linkage program. Components of the program include a county-funded hospital opioid support team (HOST), a hospital-employed addiction recovery specialist (ARS), and a medical toxicology MAT induction service and maintenance program. Data for linkage by HOST, ARS, and MAT program were tracked from July 2018 to December 2019.

Results

From July 2018 through December 2019, 1834 patients were linked to treatment: 1536 by HOST and 298 by the ARS. The most common disposition categories for patients linked by HOST were 16.73% to medically monitored detoxification, 9.38% to intensive outpatient, and 8.59% to short-term residential treatment. Among patients linked by the ARS, 65.66% were linked to outpatient treatment and 9.43% were linked directly to inpatient treatment. A total of 223 patients managed by the ARS were started on MAT by medical toxicology and linked to outpatient MAT clinic: 72.68% on buprenorphine/naloxone, 24.59% on naltrexone, 1.09% buprenorphine, and 0.55% acamprosate.

Conclusion

Implementing a MAT and linkage program in the ED and hospital setting was feasible. Leveraging medical toxicology expertise as well as community and funding partnerships was crucial to successful implementation.

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Acknowledgments

The authors acknowledge Marna Rayl Greenberg, DO, MPH, for her leadership during this project as Vice Chair of Research at Lehigh Valley Health Network Department of Emergency and Hospital Medicine. The authors would also like to thank Anita Kurt, RN, PhD for her oversight for this project as Director of Research Operations, Lehigh Valley Health Network Department of Emergency and Hospital Medicine. The authors appreciate the assistance of Lauren Crowley, LVHN Department of Emergency and Hospital Medicine Research. The authors thank J. Layne Turner, MPA and Joe Martellucci, MS of Lehigh County Drug and Alcohol Authority for their support. The authors are grateful for the support of Jennifer Smith, Secretary of Drug and Alcohol Programs, and Jodi Skiles, Director of Bureau of Treatment, Prevention and Intervention, Pennsylvania Department of Drug & Alcohol Programs. We are grateful to Pyramid Healthcare, Inc. for partnering with Lehigh Valley Health Network on our linkage to treatment and Medication for Addiction Treatment (MAT) follow-up program. The authors thank Peter Rising, MBA, MS, and Mary Ellen Bedics for their administrative support in the development of this program. We acknowledge the medical toxicologists and medical toxicology fellows in the Lehigh Valley Health Network Division of Medical Toxicology for their clinical contributions to the development of the Medication for Addiction Treatment (MAT) initiative and management of patients with substance use disorder at our institution: Matthew Cook, DO, Robert Cannon, DO, Kenneth Katz, MD, Ryan Surmaitis, DO, Andrew Koons, DO, and Alexandra Amaducci, DO. We thank Robert Cannon, DO for his contributions in the initial implementation of the Hospital Opioid Support Team and Addiction Recovery Services programs.

Funding

This study was funded in part by the Lehigh County Drug and Alcohol Authority and the Pennsylvania Department of Drug & Alcohol Programs.

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Authors and Affiliations

  1. Department of Emergency and Hospital Medicine, Lehigh Valley Health Network/University of South Florida (USF) Morsani College of Medicine, Cedar Crest Blvd & I-78, Allentown, PA, 18103, USA

    Gillian A. Beauchamp, Lexis T. Laubach, Samantha B. Esposito, Ali Yazdanyar, Paige Roth, Priyanka Lauber, Jamie Allen & David B. Burmeister

  2. Department of Emergency and Hospital Medicine, Division of Medical Toxicology, Lehigh Valley Health Network/University of South Florida (USF) Morsani College of Medicine, Cedar Crest Blvd & I-78, Allentown, PA, 18103, USA

    Gillian A. Beauchamp

  3. Air Products Center for Connected Care and Innovation, Lehigh Valley Health Network, Allentown, PA, USA

    Nathan Boateng

  4. Department of Community Health, Lehigh Valley Health Network, Allentown, PA, USA

    Samantha Shaak

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  1. Gillian A. Beauchamp
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Correspondence to Gillian A. Beauchamp.

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Beauchamp, G.A., Laubach, L.T., Esposito, S.B. et al. Implementation of a Medication for Addiction Treatment (MAT) and Linkage Program by Leveraging Community Partnerships and Medical Toxicology Expertise. J. Med. Toxicol. 17, 176–184 (2021). https://doi.org/10.1007/s13181-020-00813-4

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  • DOI: https://doi.org/10.1007/s13181-020-00813-4

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