Massachusetts Hospital To Begin Mandatory Drug Screening For Patients

By McCarton Ackerman 07/02/14

The drug epidemic in the Bay State has led to some drastic and controversial responses.

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Massachusetts General Hospital will begin the unique step of questioning all patients about their drug use, regardless of why they are receiving treatment.

Caregivers at the hospital will ask patients four specific questions about their drug and alcohol use, including whether or not they’ve used an illegal substance in the past year or how often they have more than six drinks in a night. If the responses indicate a potential addiction, a special team will be available on site to conduct “bedside interventions” or arrange for treatment if necessary. Although the hospital routinely asks patients about their drinking and drug use, it has never been done in all cases and specific mandatory questions were not part of the protocol.

“We make it incredibly hard for people to access care for addiction,’’ said Dr. Sarah Wakeman, medical director for substance use disorders at Mass General’s Center for Community Health Improvement. “Part of our goal is shifting the culture.”

National data indicates that nearly 25% of patients in the hospital for routine problems have current substance abuse disorders, but that number is likely higher in Massachusetts due to the recent epidemic of opioid abuse and subsequent overdoses.

A recent study by Massachusetts General Hospital of 2,583 patients with identified substance abuse problems showed that their hospital visits were both longer and more expensive, while their readmission rates were also higher than other patients. Their hospital stays averaged $10,000 per admission, which is up to 50% higher than patients being treated for congestive heart failure and pneumonia.

The new substance abuse prevention plan will also involve hiring five “recovery coaches”—former substance abusers who are certified by the state—to work at the hospital and in three community health centers. There are also plans to establish an addiction discharge clinic designed for patients who can’t afford a therapist or primary health care provider.

A similar, grant-funded program was run by Boston Medical Center from 2006-2011. A sample of 657 patients who received an intervention and referral to treatment from the program found their substance use had dropped from 94% in the previous month to 68%.

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McCarton Ackerman is a freelance writer and editor living in Portland, Oregon. He has been a contributor for The Fix since October 2011, writing on a wide range of topics ranging from medical marijuana in Colorado to the world's sexiest drug smugglers. Follow him on Linkedin and Twitter.