In a new initiative being launched with 11 Baltimore hospitals, the City Health Department plans to certify each one that adopts “best practices” for treating patients who overdose on opioids or are struggling with addiction.
The Levels of Care model, based on a system already used in Rhode Island, will score each city hospital from one to three based on how well they employ those practices.
Criteria will include proficiency with screening patients for addiction; connecting them to addiction-treatment resources; distributing the overdose-reversing medication naloxone; and, as Health Commissioner Dr. Leana Wen said at a press conference Monday morning, “making sure that their doctors are prescribing opioids judiciously so that we can end the cycle of addiction and overdose deaths.”
“The higher the level, the more comprehensive a hospital’s response,” Wen explained.
The Health Department is seeking public comment on the Levels of Care model through a short online questionnaire. The portal will be open through May 31.
Hospital executives and officials joined Wen and Mayor Catherine Pugh for the Monday morning announcement at City Hall. Wen highlighted the frightening jump in overdose deaths in Baltimore, which have ballooned from 167 in 2011 to more than more than 700 in all of 2016 (and 574 in just nine months in 2017), and the growing role of fentanyl—a drug 50 to 100 times more potent than heroin—in the uptick.
Dr. Renee Blanding, chief medical officer and a staff anethesiologist at Johns Hopkins Bayview Hospital, said fentanyl was once known mostly as a drug used for palliative care, chronic pain and procedures in the operating room.
“Never in all of my life did I believe that fentanyl would be killing citizens on the street,” she said.
Dr. Sam Ross, CEO of Bon Secours Baltimore Health System, highlighted the increase his West Baltimore-based hospital has seen in substance abuse issues and mental health disorders in recent years. He spoke favorably of Wen’s approach of treating addiction as a chronic disease.
Of the proposed one-to-three ranking system, he remarked: “It’s really not just about certification. It’s about, how do we provide the best-quality, safe, compassionate care for those in our community that we all have been called to serve?”
Wen said Rhode Island succeeded in driving down overdoses deaths last year. The Pew Charitable Trusts reported the state was one of 14 where overdose fatalities fell over a 12-month period that ended last July.
Wen said the health department will finalize Levels of Care criteria with partner hospitals this summer after reading feedback collected from residents, treatment providers, community groups and others. Her hope, she said, is for Baltimore to become “a national model for treating addiction, alongside every other disease.”