Access to safe abortions in the post-Roe era
Announce
Dr. Monica Saxena JD, MD joins us to discuss the recent overturning of Roe v. Wade. How will this affect access to abortions, particularly for marginalized communities? What relevance does this ruling have to the role of the EM physician in caring for emergencies in pregnancy? What role with the emergency department play in states that allow and don't allow abortions? What actions may we take for our patients, in the ED and outside the ED? Objectives 1. Explore the changing landscape of safe abortion access in the US 2. Learn how your practice in the emergency department may...
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Nutrition and Food Insecurity
Announce
Dr. Seth Berkowitz and Economist Hunt Alcott join us to discuss nutrition, food insecurity, and their relevance to emergency medicine. What questions can we ask to identify food insecurity quickly? What resources can we offer patients? How might it affect our clinical decision making?
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Alcohol
Announce
Drs. Otis Warren and Shannon Smith-Bernardin join us to discuss how alcohol relates to social issues. What more can we do for patients that are brought in drunk? What solutions exist at both the individual ED and healthcare system level?
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Health Disparities in the Time of COVID
Announce
Across the US, LatinX and Black people are dying from COVID-19 at twice the rate of their white counterparts. In this special episode of Announce, hosts Drs. Ayesha Khan & Quincy Moore explore some of the issues underlying these disparities and what EM providers need to be aware of to combat them.
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Race
Announce
Drs. Sheryl Heron and Camara Phyllis Jones join us to discuss race and how it affects our practice in the ED.
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Happy New Year!
Announce
Our team took a breather for the holidays. Tune in February 1st for another episode!
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Homelessness
Announce
In the U.S., a homeless person’s lifespan is 25 years less than average. In this episode, hosts Dr. Ayesha Khan & Dr. Quincy Moore explore how the EM providers can be pivotal in improving health outcomes for those that lack basic shelter with Dr. Kelly Doran and Stephen Brown.
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Structural determinants of health and unmet social needs
Announce
Drs. Lewis Goldfrank and Phil Levy join us to discuss structural determinants of health, unmet social needs, and what we can do to address them in the emergency department.
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Opioids
Announce
Drs. Gail D’Onofrio and Lewis Nelson join us to discuss the most up to date and practical topics related to opioids in the emergency department.
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Firearm Violence
Announce
Drs. Megan Ranney and Emmy Betz discuss the role of the emergency physician in treating firearm violence, with focus on both interpersonal violence and suicide.
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Outline the scope of the opioid epidemic as it relates to Emergency Medicine
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Detail innovative treatment options for opioid use disorder and overdose
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Discuss strategies and barriers to implementing ED-based Medication for Opioid Use Disorder (MOUD)
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Provide possible future strategies and necessary policy changes
Take-home points:
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Opioid use disorder is a disease that is often chronic and relapsing
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Prescribing buprenorphine is easy and it only takes one person to start doing it. See the show notes for resources to help.
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It’s helpful to have a champion for OUD treatment in the ED. The medical director is well positioned for this.
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Find a community champion who can help continue treatment outside of the ED
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Stigma affects both providers and patients. Learn your terms and try to be consistent with their use: opioid use disorder (OUD), Medication for Addiction Therapy (MAT), and Medication for Opioid Use Disorder (MOUD).
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Treatment for OUD can be with naltrexone, methadone, and buprenorphine. Buprenorphine is a partial opioid agonist and the best-suited for ED treatment.
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You can use the COWS score to assess your patients for opioid withdrawal.
Outside resources:
Emergency Department Contribution to the Prescription Opioid Epidemic
https://www.ncbi.nlm.nih.gov/pubmed/29373155
What Role Has Emergency Medicine Played in theOpioid Epidemic: Partner in Crime or Canary in theCoal Mine?
https://www.annemergmed.com/article/S0196-0644(18)30046-5/pdf
ACEP opioid resources
Emergency department–initiated buprenorphine/naloxone treatment for opioid dependence: a randomized clinical trial
https://www.ncbi.nlm.nih.gov/pubmed/25919527
Resources that support medication-based treatment in the ED
https://medicine.yale.edu/edbup/
https://www.bridgetotreatment.org/
Contributors:
- John Purakal
- Maureen Gang
- Caleb Scarth
- Nate Coggins
Guests:
Gail D’Onofrio, MD, MS, is the chair of emergency medicine at Yale Medicine. She is internationally known for her work in substance use disorders, women’s cardiovascular health, and mentoring physician scientists in developing independent research careers. For the past 25 years she has developed and tested interventions for alcohol, opioids and other substance use disorders, serving as the principal investigator (PI) on several large NIH, SAMSHA, and CDC studies. She is a founding Board member of Addiction Medicine, now recognized as a new specialty, subspecialty by the American Board of Medical Specialties.
Lewis Nelson, MD, is Professor and Chair of the Department of Emergency Medicine and Chief of the Division of Medical Toxicology at Rutgers New Jersey Medical School in Newark, NJ. He is a member of the Board of Directors of the American Board of Emergency Medicine and a Past-President of the American College of Medical Toxicology. He is actively involved with several governmental and professional organizations and is an editor of Goldfrank’s Toxicologic Emergencies. His areas of specific interest include consequences of opioids, pain management, and emerging drugs of abuse.