Prosecutor Joseph D. Coronato on Healthcare's Role in Breaking the Drug Addiction Cycle

The emergency department presents a crucial opportunity to reach individuals after a drug overdose and convince them to seek help “while the teardrops are warm,” according to Ocean County, NJ, Prosecutor Joseph D. Coronato. He also explained how having continuous peer support after treatment is key to preventing drug relapses.

Transcript (slightly modified)
How can hospitals encourage patients who have overdosed to get treatment? 
I think it’s important that we understand, as I said before, that there’s 3 blocks. You have education/prevention, you also have strong law enforcement, and then you have the healthcare block which is breaking the cycle of addiction. After somebody has been Narcanned, or somebody who presents themselves to the hospital who is overdosing, I think they do need to be treated a little bit differently in the emergency room, and I think you need to break that down.

I think that that person, when they’re presented to the emergency room, that we need to have a recovery coach. I think we need to have somebody who can relate to that person, somebody who’s walked the walk, because having a nurse or having a doctor talk to that person who has a substance abuse problem, that individual who’s suffering from that is not going to be able to relate to that medical personnel. Somebody who has been in their shoes is easier.

Also, we need to see whether or not, after now they’ve been given Narcan and that opiate has been driven from their system, off the neural receptors of the brain, sometimes they’re automatically going into withdrawals or they’re also having some sort of physical episode. Again, in the emergency room, are they willing to treat that with some medication, some mild medication, so that person can cope a little bit better.

I think at that point in time, as I go, if you’re going to make a difference in that person’s life, you have to get them while the teardrops are warm. You can’t let that person leave that emergency room and go back to that culture where they came from, because in my view that’s a lost opportunity. That’s where the recovery coach comes in, talks to that individual, and kind of scoops up that individual, captures that individual in that moment, and convinces that individual that, look, if they almost walked into the light, this is an opportunity to get treatment because, otherwise, you’ll pass.

Bottom line, if they do and they are successful in doing that, at that moment you could either get them into a detox facility or you get them into a treatment plan or to a rehab facility. At that point in time, you can make a difference in that person’s life. That has to happen at that time. Not saying that you can’t follow up the next day, but you’re now behind the 8-ball, so to speak, you’re trying to catch up. If you can grab that moment and convince that person at that moment, you can make a difference.

And I think the other thing with this is that we just don’t need to put people into treatment without having accountability. I’m interested in outcomes. I want to find out how long they stayed in there, once they get released, if they’re in a rehab facility either for 30 days or 60 days, then they’re doing outpatient. To say that I’m gonna make a phone call to that person, that’s another lost opportunity. It’s a disconnect.

These are a different type of individuals. They need more one-on-one; they need a mentoring system. That’s where the recovery coach comes in. They become a buddy. They come in, they’re actually, for lack of a better word, married to that individual. They do the follow-ups, they talk to them on the phone, they meet with them. When that Friday night or that Saturday night or when that person’s having an emotional breakdown and they want to go back into the dark side, go back into taking drugs again, that individual can either meet with them, can talk to them, talk them off the cliff, so to speak.

The bottom line is that that mentoring system is as important as any system that you can put in. It’s that one-on-one relationship, and that’s something that needs to be developed and needs to be going on. Because otherwise, just putting them into a facility or just putting them into a plan for whether it be 15 days, 18 days, 30 days, 60 days, it’s that outpatient support that is needed, and to me that’s important.

Then we need to see, if the outcome is not a good outcome, we need to see why and how we could’ve improved that outcome. I think healthcare has to look at this and get a handle on this, and if we can work towards that, then you can make a difference. 
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