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Overdose recovery program coming to lake

by Joe Gamm | July 29, 2022 at 4:00 a.m.

Miller County Sheriff Louie Gregoire announced this week the number of overdoses in the county has shown a dramatic increase this year compared to last.

Help will soon be coming to the Lake of the Ozarks area, officials said.

A recovery program will expand to the area possibly as soon as early September.

The rise in overdoses comes as no surprise to health care providers and administrators who have struggled to reduce the number of fatal overdoses that surged around 2013. The nonprofit Behavioral Health Network of Greater St. Louis in 2015 created programs to help stem the rising tide of fatal overdoses, according to Shawn Billings, Missouri Hospital Association vice president of substance use programming.

Efforts led to the 2018 launch of Engaging Patients in Care Coordination (EPICC), a program connecting hospital emergency room patients with substance use treatment and grassroots recovery support. The MHA, Behavioral Health Network, state Department of Mental Health, Missouri Institute for Mental Health and other agencies teamed up to identify other communities, beyond St. Louis, and expand the EPICC program to those. In 2019, the program reached Columbia, then Kansas City, then Springfield. It employs 13 people full time in St. Louis, four in Columbia, five in Springfield and six in the Kansas City area.

Program organizers chose the areas of expansion based on overdose data, Billings said.

In Jefferson City, Capital Region Medical Center is a partner health center, and Compass Health Network, Phoenix Health Programs and Preferred Family Healthcare, Inc., are treatment providers in the program.

EPICC will next, possibly by early September, serve Lake Regional Hospital with two full-time employees, Billings said.

EPICC uses Missouri-certified peer specialists (who have substance use disorder histories), known as recovery coaches, to encourage clients' engagement with community treatment providers through intensive outreach services, according to a 2020 EPICC status report, which may be found at https://www.mhanet.com/mhaimages/SQI/SUD/EPICC_Status_Report_2020.pdf.

During the past 29 months, especially with the pandemic, patients hadn't been going to hospitals, Billings said.

"Hospitals are just rock stars," he said. "They are intentionally serving more thoughtfully in this space."

He said hospitals find ways to find treatment for patients without causing them to go sideways with law enforcement.

Recovery coaches, dispatched 24 hours a day, seven days a week through dedicated hotlines, establish immediate links to substance use and medication-assisted treatment services. They also case-manage needs associated with housing, transportation, access to technology and more.

"We do our best to respond bedside within 60 minutes of referrals," Billings said.

For example, he said, suppose it's 2 a.m. Saturday and a community member nearly lost his life, but was saved through the application of naloxone. He gets dropped off at an emergency room.

"I'm stabilized. What they're going to do is provide me -- if medically appropriate -- with buprenorphine treatment," Billings said.

Buprenorphine diminishes the physical dependency of opioids, such as withdrawal symptoms and cravings.

Unfortunately, if it is 2 a.m. Saturday, patients aren't going to get "bridge prescriptions" to hold them until Monday, when pharmacies open.

"Recovery coaches are helping with that prescription," Billings said. "(Patients) are in withdrawal and in intense cravings. If we don't treat them, they are going to go back to the street and die. It takes away those intense cravings."

Coaches also help patients who face food insecurity, unemployment, homelessness, transportation challenges and difficulty with the legal system.

"We have to circumvent all of that," Billings said. "We have flex funds to help out with housing and childcare -- all those care needs that community members have. This is a whole-person approach that starts in the four walls of the hospital."

He said it takes the understanding that when some of those needs aren't met, the likelihood of relapse is heightened.

Beside Lake Regional Hospital, other areas where the program is preparing to expand are in or near the Bootheel.

Stakeholders are working with Poplar Bluff Regional Hospital and Missouri Highlands Health Care, a federally qualified health center, where planning is under way.

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