How a trip to the emergency room can be an avenue to addiction treatment

UCHealth Yampa Valley Medical Center Emergency Department uses a multi-faceted approach to connect patients with addiction services

Ken Lingle, left, is a registered nurse, and Dr. Jim Cotter, right, is an emergency medicine physician at UCHealth Yampa Valley Medical Center in Steamboat Springs. For some, a trip to the emergency department can be an avenue for getting connected with addiction help. (Photo by John F. Russell)

Last year, UCHealth Yampa Valley Medical Center in Steamboat Springs saw 166 patients in its emergency department whose primary diagnosis was alcohol abuse or dependence. For another 118, alcohol abuse or dependency was a secondary or other part of a diagnosis, according to statistics from the hospital.

Lacking other options, many people wind up in the emergency department, where Dr. Jim Cotter, an emergency medicine physician, and Ken Lingle, a registered nurse, may treat them.

Generally, if it is something simple like someone who is too drunk, law enforcement will find a sober person to take care of them, Cotter said. If the case is more serious, like the person also sustained some sort of trauma or could be a danger to themselves or others, they are often brought to the emergency department.

Sometimes, after a medical evaluation and treatment, staff will work to find the patient a safe way home, but if more care is needed, recent renovations at the hospital added two patient watch rooms, where they can be monitored in a safe place. In 2020, there were 281 patients who used these rooms.

“When they are impaired, they can have time to just let that alcohol work through their system, and sometimes, that’s all they need,” Lingle said.

The rooms can be cleared of equipment easily, have dimmable lights and are the only two rooms in the department with TVs. If someone is in the room, there is someone watching them at all times, Cotter said.

Cotter said through most of his career, the nature of emergency medicine has been to treat the immediate problem rather than take additional steps toward prevention. But it is different at YVMC, he said, as they have a system to flag certain cases for follow up to offer additional help.

It starts with screening questions that nurses like Lingle ask when a patient comes in, but they also have access to a patient’s previous behavioral health records.

“They may be someone that we’ve seen a handful of times for being drunk, but maybe not on that full-fledged alcoholism, that will flag behavioral health case management,” Cotter said.

From there, someone from behavioral health can help connect them with services like a 12-step program or treatment. Even if someone isn’t flagged by the system, case managers will keep their eyes on cases in the emergency department to potentially offer services.

In some cases, the hospital is the best place for a person to deal with an emergency situation stemming from drug or alcohol abuse. But Cotter said when patients they see haven’t sought out any resources, it is often because they are unaware of them or lack someone to help them understand what help is available.

Others they see have sought treatment or other services, sometimes through UCHealth, and Lingle said they can help them get reconnected to those services.

“We’re dealing with an acute problem,” Lingle said. “They may already have those resources, but something may have happened to cause a particular situation, and there is nowhere else to go at the time.”

UCHealth can offer access to its services across the state, with inpatient facilities on the Front Range or other providers in Grand Junction, said hospital spokesperson Lindsey Reznicek. While transportation to these places is still a barrier, she said UCHealth has made significant investments to add bed space in the state.

“Maybe they’ve thought there are no other options for them, and they are at the end of the line,” Lingle said. “You want to give them the best resources you have in an environment that doesn’t have a lot of resources.”

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