This is an emergency, preparing for a safe landing: Lessons from an overdose prevention project located in an emergency department

Background:. Incidence of death from overdose in Allegheny County has increased 400% between 1980 and 2011. An evaluation indicated that many individuals who died from overdose previously accessed EDs during a nonfatal overdose. Objectives: Implement an evidence-based program within an ED that can provide services to patients who have or are at risk for overdose, and demonstrate that this program requires limited funding and can be sustained over time. Methods: The Allegheny Country Overdose Prevention Coalition (ACOPC) developed in 2010 the Safe Landing project. This project, universally screens adult patients in the ED for problem substance use and conducts brief interventions with those at elevated risk. Patients identified at risk for overdose are offered facilitated access to treatment services and recovery support. Patients are provided educational materials and instructed on measures to reduce their overdose risk, some will be provided a rescue drug. Results: During 2012, over 40,000 patients were screened, with nearly 3,400 assessed in depth regarding their substance use and provided safety education. Brief Interventions were conducted with 914 and linked to behavioral health services. At least, nineteen direct linkages to recovery support partners were successfully recorded in 2012. The program is embedded within the EMR and provides for passive billing using prevailing SBIRT billing code, used to sustain the program. Conclusions: An ED-based program has potential to implement and sustain a program that will reduce patient overdose risk. Recommendations: Concerned parties should consider implementing a similar ED-based program as a way of reducing their community's overdose risk