Banning, CA.  (July 30, 2019) –San Gorgonio Memorial Hospital (SGMH) is among 31 health facilities selected from across the state to participate in the California Bridge Program.  Many people are not only aware of the opioid crisis, but also personally know someone affected by it. While solutions to this crisis can at first seem daunting, difficult, or even impossible, change is on the horizon. This CA Bridge Grant funded by the Public Health Institute brings funding, training, and technical assistance to select hospitals in California to combat the opioid crisis in a robust and meaningful way. This allows the Emergency Department to provide around-the-clock access to treatment for substance use disorders.

The opioid crisis often hits rural counties the hardest. According to the California Department of Public Health, in 2017 the rate of opioid overdose deaths was more than twice as high in the Riverside County (140 (5.7 / 100k) as compared with the California state average (309 (12.3/ 100k). While the County was lower than the state average for opioid overdose deaths (216(8.1/100k), it still had a significant number of opioid overdose hospitalizations.

In addition, in 2017, there were 195 overdose deaths involving prescription opioids. 111 overdose deaths involved Heroin, 184 overdose deaths involved Synthetic opioids. Fentanyl involved deaths have continued a dramatic rise since 2015, increasing 86% from 2016-2017.

Despite the magnitude of the problem, the creators of the California Bridge program realize a few very important keys to success. Previously, a referral to an addiction treatment program was the most that hospitals were generally able to provide for patients identified as needing treatment for Opioid Use Disorder. This referral was fraught with barriers: the need to effectively control withdrawal symptoms, financial barriers, transportation issues, and system navigation barriers. The new Bridge model uses emergency departments to initiate long-lasting, successful treatment for Opioid Use Disorders.

Many of these patients are on Medi-Cal and there are a large population of homeless individuals served as well. “We have a large catchment area and see a lot of patients who are socioeconomically disadvantaged,” “Patients often have difficulty accessing health care services and many struggle with substance use issues. When patients in opioid withdrawal come seeking medical care in the Emergency Department, including for reasons not related to opioid use, they will be offered a dose of medication such as buprenorphine to ease severe symptoms of withdrawal, and then they will be connected with outpatient treatment in the community. Studies have shown that patients given medication designed for addiction treatment are more likely to remain in care than those who are given referral information alone.

“By suppressing withdrawal long enough to create a bridge for patients to enter and remain in treatment, physicians can save lives,” said Andrew Herring, MD, Director of Emergency Department Services for the Bridge program. “We know this model works, and now we are bringing it to hospitals and emergency rooms all across the state that are anxious for real solutions to address the enormous pain and suffering they see every day caused by the opioid epidemic.” “This will help our patients in our community return to more healthy, productive lives,” said Julie Kasarjian, MD, PhD Director of the Emergency Department and CA Bridge Program at San Gorgonio.

Establishing the Bridge program at San Gorgonio Memorial Hospital means that anyone, anytime, in our community can access the best evidence-based treatment for opioid use disorder. Our Emergency Department physicians and PA/NPs are being trained to treat an individual’s opioid withdrawal symptoms with the medication buprenorphine, which is quick to work, safe and very effective. Our Emergency Department providers also work closely with our Substance Use Navigator (SUN). The SUN position is entirely new concept. They serve to support the patient throughout the entire process, from admission into the Emergency Department through transition to continued outpatient treatment. We have partnered with several local primary care clinics and substance use treatment centers in the area, thereby creating a network around our Emergency Department hub, ready to meet each individual’s unique situational needs.

If you or anyone you know is concerned about their opioid use and wants to explore ways to get into treatment, please call our Substance Use Navigator. Ms. Cynthia Garcia, at (951) 492-5306. She can also be reached by email at Cagarcia@sgmh.org. Whether in the Emergency Department or not, Ms. Garcia is able to answer questions and help guide individuals through the steps to outpatient treatment.

California Bridge Program Selected Sites Include:

Adventist Health Howard Memorial Hospital – Willits Adventist Health and Rideout – Marysville Arrowhead Regional Medical Center – Colton Central California Faculty Medical Group – Fresno Contra Costa Regional Medical Center – Martinez Dignity Health Memorial Hospital – Bakersfield El Centro Regional Medical Center – El Centro Enloe Medical Center – Chico Hanford Community Hospital – Hanford Harbor-UCLA Medical Center – Torrance Highland Hospital – Oakland Kaweah Delta Hospital Foundation – Visalia Marshall Medical Center – Placerville Northern Inyo Hospital – Bishop Olive View-UCLA Education & Research Institute – Los Angeles Shasta Regional Medical Center Prime Healthcare – Services – Redding San Gorgonio Memorial Hospital – Banning Santa Barbara Cottage Hospital Santa Clara Valley Medical Center – San Jose Santa Rosa Community Health Brookwood Campus – Santa Rosa Scripps Mercy Hospital – San Diego Sierra Nevada Memorial Miners Hospital – Grass Valley St. Joseph Health & St. Mary’s Medical Center – Apple Valley St. Joseph Hospital – Eureka St. Joseph’s Medical Center – Stockton Sutter Lakeside Emergency Department – Lakeport UC Davis Health – Sacramento UC Irvine Medical Center – Orange UC San Diego Health – San Diego UCSF Medical Center – San Francisco The Wellness Center – Los Angeles