BRUNSWICK

On the front lines of America’s opioid crisis, a hospital’s emergency department has become a safety net for those afflicted with addiction. Mid Coast Hospital’s emergency department in Brunswick is no different — but it’s method of treatment is.

The emergency department has begun administrating willing patients with Suboxone, a medication that treats withdrawal symptoms.

“Every day we see someone here with either an opiate, alcohol problem or some other substance problem,” said Dr. Ranjiv Advani, director of the Mid Coast Hospital Emergency Department. “Our providers were increasingly becoming frustrated with the lack of options to direct those people to care, because in an emergency department we can’t provide definitive care for a long-term chronic illness.”

Suboxone is an opiate-like substance that doesn’t activate the opiate receptor with the same strength as heroin, Oxycodone or morphine, Advani said, so it relieves the withdrawal — without the euphoria of other opiates or the danger of overdose.

The emergency department has prescribed Suboxone approximately six times in the last six months.

“It’s not a frequent event, but it’s obviously a huge impact event for that person’s life and their family and children,” Advani said.

Following their release from the emergency department, patients receive treatment a couple of days later at one of Mid Coast’s Addiction Resource Centers in Brunswick or Damariscotta.

Advani estimated two dozen people have been referred to the center for treatment for their opiate use disorder or for a low-risk alcohol withdrawals.

“Our Addiction Resource Center has really prioritized access for these people,” Advani said, “because addiction is kind of one of these things where you need to catch people when they’re motivated and in the ER, (where) they’re commonly motivated because they’ve hit a low point for some reason.”

At any given time, there are approximately 250 patients in the medicated assisted treatment program in centers.

“It’s a need, because the opiate crisis is continuing to worsen and people continue to die in larger numbers,” said Dr. Leah Bauer of the Mid Coast Hospital Addiction Resource Center. “There’s a lot we can do better and a lot of room for improvement. I thought this is one thing that could help keep things moving in the right direction.”

According to data compiled by the Associated Press, overdose deaths involving opioids — prescription painkillers and illicit drugs such as heroine included — have spiked dramatically since 2000. In 2015, for example, more than 52,400 Americans died from overdosing on opioids.

In Maine, emergency department visits for suspected opioid visits jumped by 34 percent from 2016 to 2017, according to a March report by the Portland Press Herald, which noted 418 deaths as a result of drug overdoses in 2017.

Advani said that while the opioid crisis worsens, “At the same time, mostly because of financial concerns, a lot of treatment facilities, and especially inpatient care, have been closed down over the last several years.”

Connecting an addict “with the person who can take care of them is essential care,” Advani added.

Advani said Mid Coast’s program, based on a 2015 Yale study, is “a better pathway for people who have substance abuse or substance use problems, including alcohol, and get them to the ARC where they can get definitive care.”

Mid Coast’s is the first such program in Maine, although Advani believes in five or 10 years it will become a standard for many other emergency departments.

“But right now we’re trying to get the word out to encourage people to do it,” he said. “Unfortunately, this is a patient population that is often neglected, commonly stigmatized and very sensitive to judgment. The medical community is just now starting to realize that we need to send a message that we’re here to help.”

dmoore@timesrecord.com