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NYC Health + Hospitals Redesigns Treatment Model to Help and Support New Yorkers With Substance Use Disorders

Redesigned model provides New Yorkers access to a number of program options and services in different settings to help address the many challenges and stigmas associated with these disorders

Model is being rolled out across the City's public health system and is anticipated to be complete by Fall 2021

Aug 12, 2020

New York, NY

NYC Health + Hospitals today announced that it is redesigning its treatment model used to help and support New Yorkers with substance use disorders (SUDs). The redesigned model provides New Yorkers access to a number of program options and services in different settings to help address the many challenges and stigmas associated with these disorders. Out-patient detox approaches will be offered in nearly every care setting within the public health system – from addiction consultation in all 11 hospital emergency departments (EDs) and select in-patient units, to traditional Methadone services, and support for substance use in primary care. NYC Health + Hospitals is also adding additional services, including in-patient rehab, and other evidence-based programs. These approaches offer patients with SUDs treatment options throughout the system so that patients can access care quickly and effectively. The combination of services offered in the new model applied to in- and out-patient settings address the complexities of SUDs with the best possible care and long-term health outcomes. The redesigned modelis being rolled out across the City’s public health system and is anticipated to be complete by fall 2021.

SUDs is a disease that affects a person’s brain and behavior and leads to an inability to control the use of drugs, medication, and/or alcohol. Whether someone is combatting alcohol, opioids, or other drug addictions, NYC Health + Hospitals’ comprehensive service model provides New Yorkers with the most appropriate level of care to increase positive, long-term outcomes. By providing SUDs care throughout the system, NYC Health + Hospitals is working to ensure easy access to effective care, while supporting patients to remain in their communities with the support of their families and friends.

“One of our priorities as the City’s public health system is to provide personalized care to meet the diverse and complex needs of our patients and communities, meeting them where they most need our support,” said NYC Health + Hospitals President and CEO Mitchell Katz, MD. “By providing a wide range of evidence-based, flexible treatment options with rapid connection from in-to-out-patient care, we are working hard to help New Yorkers heal and find the recovery that works for each individual. The new detox model both destigmatizes the process and ensures patients with complex medical needs are treated for all of their needs at once.”

“Our health system is committed to providing safe, effective, and appropriate treatments for New Yorkers with substance use disorders in a compassionate environment,” said NYC Health + Hospitals Deputy Chief Medical Officer and Director of the Office of Behavioral Health Charles Barron, MD. “Substance use disorders are complex and impact individuals differently. Therefore, transitioning to provide a number of detox programs in different settings and timelines to our patients was the only logical decision to ensure long-term, successful outcomes.”

“At NYC Health + Hospitals, we want to open as many doors and extend as many hands as someone needs to find healing for themselves and their families,” said NYC Health + Hospitals Assistant Vice President of the Office of Behavioral Health Rebecca Linn-Walton, Ph.D., LCSW. “We believe in helping our patients find their own path to recovery, while emphasizing that there is no wrong way or wrong time to come seek the necessary support to overcome substance use disorders. Family is a vital support in this journey, and we work hard to keep our patients connected to family, friends, and their community.”

NYC Health + Hospitals’ redesigned model relies on four primary components, which include:

— Treatment Directly in Emergency Departments (EDs)– This approach targets opioid use disorders, utilizing medication assisted treatments and support from recovery peer advocates and licensed counselors. This approach links patients to long-term treatments in out-patient settings, including clinics and primary care.

— Medical In-Patient Stabilization– In-patient addiction consult teams, which consist of providers, licensed counselors, and recovery peer advocates, in the public hospital system’s acute care setting treat patients with acute withdrawal from opiates or alcohol through evidenced-based methods. Through this method, specialized peers and social workers engage patients and link them to ongoing treatments, such as 28-day rehabs or out-patient substance abuse clinics. This approach also provides education to in-patient medicine teams in order to increase sustainable capacity for addiction treatment of patients.

— Intensive Out-Patient Detox– Patients with substance use disorders who do not require hospitalization will be referred to out-patient services to help them stabilize and connect to ongoing addiction treatment while remaining in the community. This approach is most commonly used for individuals seeking to stabilize on a maintenance dose or gradually taper off medications or other substances, such as alcohol, opioids, or benzodiazepines. This service is run through NYC Health + Hospitals’ Office of Addiction Services and Supports (OASAS) certified clinics by addiction specialists that allows for rapid evaluation, triage, and medication-assisted treatment (MAT). With regularly scheduled sessions, this service addresses mild-to-moderate withdrawal. Out-patient intensive detox is available at select locations throughout the boroughs, including NYC Health + Hospitals/Bellevue, Coney Island, Kings County, Jacobi, and Woodhull.

— Virtual Buprenorphine Clinic– As a response to the COVID-19 pandemic, NYC Health + Hospitals/Bellevue began operating the system’s first virtual buprenorphine clinic that serves all New Yorkers looking to start buprenorphine treatment or find themselves with a gap in coverage to treat their opioid use disorder. The virtual clinic focuses on rapidly evaluating and treating patients and generally can be done on the very same day they call the clinic. The clinic aims to encourage patient safety, reduce the burden of opioid overdose, and promote harm reduction while reducing barriers to receiving treatment during this period of emergency.

“Today’s NYC Health + Hospitals announcement of the redesign model of it behavioral services treatment is well received and long overdue,” said Chair of the Council Committee on Mental Health, Disabilities, and Addictions Diana Ayala. “In order to really effectuate change and to assist individuals in receiving the needed services that will help guide them towards recovery, it is important that we begin at the first point of contact, and that often happens in the emergency room. This is a very important first step and I am sure that it will allow individual treatment options and will help reduce the stigma that often surrounds those seeking assistance.”

In December 2019, Dr. Katz announced the transition of the public hospital system’s existing detox beds in all seven of its existing detox units. Instead of staffing underutilized, outdated units, staff are being transitioned into similar roles in the system’s detox remodeled approach. Staff will engage patients in more effective ways, leading both to better success for patients and ensure staff find their work meaningful and rewarding. Instead of seeing patients cycle through the same short-term treatment, staff will help them heal and progress through effective treatment.

Traditional in-patient detox programs, which was previously the standard-of-care and used by NYC Health + Hospitals until recently, provided a limited scope of services in a narrow timeframe that didn’t support long-term, positive outcomes for patients battling SUDs. Patients had to arrive to the EDs during the short period when detox symptoms appeared, could only be treated for opioid withdrawal or alcohol withdrawal not requiring the ICU, and left in great risk of relapsing after leaving, or returning soon after release to our facilities.

For more information about Substance Use Disorders Services at NYC Health + Hospitals, visit the Mental Health Care webpage. Patients can make an appointment by calling 844-NYC-4NYC.