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What Is the ‘Warm Hand-Off’ and How Can It Help Pennsylvania’s Opioid Abuse Crisis?

Note: Guest blogger Kristen Sandel, MD, is associate director of emergency medicine at Reading Hospital.

Over the past few months, stories concerning the opioid crisis have garnered front page news throughout the United States. Unfortunately, Pennsylvania has not been spared.

The number of individuals who have overdosed on opioids increased dramatically over the past few years. PAMED and the Commonwealth of Pennsylvania have teamed up to fight this battle together and have launched a number of initiatives, including education on the "Warm Hand-off" (also called "referral for treatment") to aid in the identification and treatment of individuals addicted to opioids.

Fortunately, largely due to the efforts of the Pennsylvania Physician General, Dr. Rachel Levine, and the Secretary of Drug and Alcohol Programs, Gary Tennis, naloxone has been available to first responders, as well as the general public, for the rapid reversal of opioid overdoses. Many of those patients who have received this life-saving intervention subsequently present to emergency departments for further evaluation and treatment of both medical and, in some cases, mental health concerns.

It is during this hospital visit that the warm handoff should be initiated. The goal of this initiative is to ensure that patients who are identified with an opioid addiction be offered a treatment plan immediately following the resolution of their medical emergency.

Due to the lack of available inpatient rehabilitation centers in some areas of Pennsylvania, patients were previously given resources and discharged from the hospital without a proper recovery plan in place. The warm hand-off begins to address this issue and places these individuals in direct contact with recovery experts to begin the intervention, assessment, and referral to treatment prior to their discharge.

Patients are contacted either in person or by phone by recovery experts and the next step in their road to recovery is discussed.

To date, there have been numerous patients throughout the Commonwealth whose lives have been saved by naloxone due to the efforts of first responders and their ability to use this life-saving medication. More recently, due to the availability of the warm hand-off program, patients in the Commonwealth have been given the opportunity to commence their recovery immediately following the life-saving intervention that they received.

At the Reading Hospital's Emergency Department, we are already seeing an increase in patients' willingness to accept this important intervention and start their path to recovery.

Reading Hospital has developed a plan in conjunction with the Council on Chemical Abuse (COCA) to identify and refer patients in need of assistance directly to specialists in real time. Also, by creating a "hard stop" in our electronic health record when caring for and ordering consultations for mental health and substance abuse patients, we have been able to increase physician awareness of this life-saving process and ensure a greater utilization of this resource.

We are hopeful that we will continue to see increases in the number of warm hand-offs and subsequently see a decline in the opioid overdose population.

PAMED has been a leader in many of the initiatives to combat the opioid crisis on multiple levels and has been working closely with the Commonwealth of Pennsylvania to develop programs as well as educate both patients and physicians concerning this epidemic. 

Want to learn more effective strategies to encourage struggling patients to seek treatment for their opioid addition? Take this online, on-demand CME course.

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