ACEP Hosts Summit on Impact of Stigma and OUD in Emergency Settings

On January 23, 2020, the American College of Emergency Physicians (ACEP) convened a summit, “Addressing the Opioid Stigma in the Emergency Department.” The summit gathered a diverse group of organizations and representatives to discuss and share ideas to gain insight into the prevalence, effect and targeted solutions to limit the impact of stigma on the care of ED patients with opioid use disorder (OUD). ACEP is part of a large coalition of national professional organizations that make up the Opioid Response Network (ORN), which is led by the American Academy of Addiction Psychiatry and funded by the Substance Abuse and Mental Health Services Administration.

Objectives for the summit included

• Acknowledge the existence of stigma related to opioid use in the ED and the resulting barriers to the delivery of quality patient care. 
• Identify strategies and behaviors to reduce practices that perpetuate stigma in the ED.
• Discover innovative solutions to combat stigma in the ED.
• Provide consensus recommendations for best practices and future research in the areas of administrative policies and procedures, education, and research. 

Summit participation included representation from

• Federal partners (Department of Health and Human Services, Center for Disease Control and Prevention, Substance Abuse and Mental Health Services Administration, Drug Enforcement Agency and National Institute on Drug Abuse).
• Health care physicians and providers (emergency medicine representation from the American College of Emergency Physicians, American Academy of Emergency Medicine, Society of Academic Emergency Medicine, Emergency Nurses Association, Society of Emergency Physician Assistants, and Emergency Medicine Residents’ Association; addiction and psychiatry representation from the American Society of Addiction Medicine and American Academy of Addiction Psychiatry)
• Other partners (American Medical Association, National Council for Behavioral Health, Harm Reduction Coalition, National Association of EMS Physicians, National Association of Emergency Medical Technicians, Coalition for Psychiatric Emergencies, Pew Charitable Trust Foundation, Foundation for Opioid Response Efforts and Emergency Department Sickle Cell Care Coalition)
• Individuals who have experienced stigma related to a personal history of substance use.

Through targeted breakout sessions that developed specific recommendations based on consensus, attendees developed concrete strategies to reduce stigma and improve the experience for ED patients with opioid use. Attendees used stories from ED patients with OUD and recommendations for previously enacted successful strategies from other professional organizations to develop these strategies. Using information from the presentations, panel and breakout sessions, ACEP plans to develop a publication that will describe the conference proceedings and specific recommendations for ED policies, education, strategies to engage hospital leadership, patients and families and future research priorities. A short video featuring interviews with former ED patients with OUD sharing their experiences and strategies to improve care will be highlighted, alongside ED physician interviews, to convey the impact of stigma around OUD in the ED and the opportunities to improve care.

Funding

Funding for this initiative was made possible (in part) by grant no. 6H79TI080816 from SAMHSA. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Kathryn Hawk, MD, MHS
Assistant Professor of Emergency Medicine
Yale University School of Medicine 
NIDA Drug Use, Addiction, and HIV Scholar 

Sam Shahid, MBBS, MPH
Practice Management Manager 
American College of Emergency Physicians