Reducing Harm: Bridging Patients between Prisons and Clinicians to Treat Opiate Addiction
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- Meghan Rich
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1 Reducing Harm: Bridging Patients between Prisons and Clinicians to Treat Opiate Addiction Britt Carney, GSN Sam Fountain, SOM Catherine Jones, GSN John Mandeville, GSN Jason Shaffer, SOM 1
2 Presentation Objectives Define system and population of focus Explore the roles of interprofessional teams Identify the systems and teams involved Identify opportunities for future population health advocacy Vision statement Recommendations & next steps Acknowledgements 2
3 Population Barre, MA Rural town in north-central Worcester County Demographics 5,398 residents (2010 Census) Primarily Caucasian & English Speaking Median income of $43,650 (6.59% poverty rate) 1 Unique factors Rural environment with limited transportation access & financial constraints Opioid use Barre s 2015 OD rate is >15.4 deaths/100,000 2 Post-incarceration vulnerability Uniquely vulnerable post-release 40-fold increase risk of overdose 1 Multiple barriers to follow up with a PCP or with addiction treatment 1. DATA USA MA Department of Public Health Chapter 55 Data Brief. Figure from:ma Department of Public Health Chapter 55 Data Brief. cuments/2017/08/31/data-brie f-chapter-55-aug-2017.pdf 3
4 System Community: Barre Family Health Center s Office Based Addiction Treatment (OBAT) Program Treat OUD in primary care including use of medication-assisted treatment (i.e. buprenorphine) If incarcerated: Access to medication treatment can stop Post-incarceration: Can be challenging to engage in care and follow-up with a PCP or with addiction treatment Goal: help bridge this population to addiction treatment/pcp providers while maintaining engagement in care. 4
5 Teams & Settings Barre Family Health Center Medical, Nursing, Behavioral Health Worcester County Jail Medical, Psychology, Nursing, Case Management 966 inmates, 83% white, 66% of inmates test + for opioids on admission Vivitrol upon release (If requested) is only option Hampden County Jail Medical, Psychology, Community Health/Primary Care, Nursing, Social Work, Case Management 1,348 inmates Section 35 Franklin County Jail Medical, Nursing, Social Work, Case Management, Psychology ~250 inmates, over 90% white, both male and female inmates Re-entry Case Workers 5
6 Advocacy 6
7 Mission Statement: Engagement in Care Community Incarceration Pre-release Planning Post-incarceration BFHC OBAT Clinic Medication treatment for OUD Behavioral health Transportation needs met Recovery support community (e.g., 12-step, ACT, mindfulness, recovery center) SU Assessment Medication tx maintained (offered options) Check MassPAT On-going assessment of craving and withdrawal sx Psychiatric assessment if needed Communication (via ROI) with BFHC about incarceration and existing tx plan Case worker assigned Planning for needs upon release (e.g., housing, jobs, recovery support) PCP appointments made & communication about release with BFHC Overdose education & naloxone in hand Same day follow-up with BFHC OBAT team Recovery community supports & recovery engagement access Behavioral health 7
8 Recommendations & Next Steps 8
9 Acknowledgements Dr. Kristina Gracey Dr. Cynthia Jeremiah Adele Ojeda, LPN, Office-based Addiction Treatment (OBAT) Program Barre Family Health Center Chief John Carbone, Barre Police Department Nekr Jenkins & Kathy Inman, Quabbin Drug Response Unifying Group (Q-Drug) Barre Family Pharmacy David Tuttle, Superintendent of Worcester County Jail Rich Kenny, UMass Memorial Recovery Coach Richard Brathwaite, CCHP, Assistant Superintendent Health Services Department, Hampden County Sheriff s Office Hampden County Sheriff s Office, Health Services Department Levin Schwartz, Director of Clinical & Re-entry Services, Franklin County Sheriff s Office Ken Chartrand, Re-entry Caseworker, Franklin County Sheriff s Office Ruben Mercado, Re-entry Caseworker, Franklin County Sheriff s Office 9
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