City Hospital Emergency Departments Adopt Guidance to Prevent Future Overdoses
31 hospital emergency departments have agreed to adopt the guidance, including all NYC Health + Hospitals locations
More than 10,000 non-fatal overdoses are treated in New York City hospital emergency departments each year
May 31, 2019 — As part of HealingNYC, 31 New York City hospital emergency departments have agreed to adopt the Health Department’s non-fatal overdose guidance. The guidance — which will be implemented in all 11 NYC Health + Hospitals emergency departments — encourages emergency clinicians to: provide overdose prevention education, including risk reduction strategies; offer naloxone, the medication to reverse an opioid overdose; and recommend ongoing care, including the effective opioid addiction treatments buprenorphine or methadone. Emergency department providers are uniquely positioned to address the opioid overdose crisis because they regularly provide medical care to patients who have overdosed. More than 10,000 non-fatal overdoses are treated each year in New York City hospital emergency departments. Non-fatal overdose is a strong predictor of future fatal overdose. A 10-year retrospective study in a large healthcare system found about one in 10 patients died within 12 months after having one or more opioid-related overdoses. However, standardized guidance for opioid overdose prevention for emergency departments is limited. Read the full guidance (PDF) and poster (PDF).
“Emergency medicine clinicians are on the front lines of the opioid overdose epidemic,” said Health Commissioner Dr. Oxiris Barbot. “Our new guidance can help these providers keep their patients safe from future harm with proven, multifaceted overdose prevention strategies.”
Participating hospitals are located in 11 of the 16 neighborhoods with the highest rates of drug overdose death. The following hospitals will adopt the guidance:
Bronx
- Jack D. Weiler Hospital (Einstein Campus)
- Montefiore Hospital (Moses Campus)
- Montefiore Wakefield Hospital (Wakefield Campus)
- NYC Health + Hospitals/Jacobi
- NYC Health + Hospitals/Lincoln
- NYC Health + Hospitals/North Central Bronx
Brooklyn
- Maimonides Medical Center
- Mount Sinai Brooklyn
- NYC Health + Hospitals/Coney Island
- NYC Health + Hospitals/Kings County
- NYC Health + Hospitals/Woodhull
- NYU Langone Health–Cobble Hill
- NYU Langone Hospital–Brooklyn
Queens
- Mount Sinai Queens
- NYC Health + Hospitals/Elmhurst
- NYC Health + Hospitals/Queens
Manhattan
- Mount Sinai Beth Israel
- Mount Sinai Hospital
- Mount Sinai St. Luke’s
- Mount Sinai West
- NewYork-Presbyterian/Columbia University Medical Center
- NewYork-Presbyterian/Weill Cornell Irving Medical Center
- NewYork-Presbyterian Allen Hospital
- NewYork-Presbyterian Lower Manhattan Hospital
- NYC Health + Hospitals/Bellevue
- NYC Health + Hospitals/Harlem
- NYC Health + Hospitals/Metropolitan
- NYU Tisch Hospital
Staten Island
- Richmond University Medical Center
- Staten Island University Hospital – North campus
- Staten Island University Hospital – South campus
“NYC Health + Hospitals emergency departments see thousands of patients every year, including many who have experienced a non-fatal opioid overdose. It’s important our patients receive the support, information, and care they need during this critical time in the emergency room, which is why all 11 of our hospitals are adopting the Health Department’s guidance,” said Dr. Machelle Allen, Chief Medical Officer at NYC Health + Hospitals.
“I’m encouraged that the Health Department is taking forthright steps to standardize counseling for New York City emergency department patients who’ve survived drug overdoses. Providing drug users with strategies for risk and harm reduction can help keep them safe and offer a pathway out of addiction,” said Assembly Member Richard N. Gottfried, Chair of the Assembly Health Committee.
“The drug epidemic is still devastating communities across our borough, and in order to find a solution, physicians need to be a part of the answer. Thank you to the Department of Health for creating this guidance to encourage clinicians to provide the vital education for overdose prevention and treatment options that many New Yorkers need,” said Staten Island Borough President James Oddo.
“Richmond University Medical Center has long been a leader in implementing effective integrated behavioral medicine protocols to provide comprehensive mental health and substance use disorder treatment,” President and CEO of Richmond University Medical Center, Dr. Daniel J. Messina said. “From being among the first medical facilities in the city to offer buprenorphine treatment in our emergency department, to implementing a successful recovery peer advocate program also in our emergency department, joining with the Department of Health and Mental Hygiene on this new initiative provides us with another effective tool to help us assist those struggling with addiction.”
“We are incredibly proud to affirm our commitment to follow the recommendations laid out in this document along with the leaders from a multitude of other medical centers in NYC,” said Robert J. Femia, MD, MBA, Chair of the Ronald O. Perelman Department of Emergency Medicine at NYU Langone Health. “Many members of our organization were involved in crafting this document, and we believe it represents a great step forward in standardizing the approach to combatting the opioid epidemic. Here at NYU Langone Health, we are deeply committed to doing our part to help combat the opioid crisis. We take very seriously our responsibility to help aide those in our communities suffering from this devastating addiction crisis, whether they be patients or their friends and families.”
“The Mount Sinai Health System has proudly collaborated with the NYC Health Department to expand emergency department-based medication-assisted treatment for patients with opioid use disorder and reduce the chances of recurrent overdose with evidence-based harm reduction strategies. We look forward to our continued partnership with the health department to turn the tide of rising opioid overdose-related deaths,” said Jeremy Boal, MD, Chief Clinical Officer, Mount Sinai Health System.
“A third of the population of Staten Island walks through our emergency departments each year. To provide the knowledge and resources to combat overdose and addiction for themselves, or their loved ones is part of our mission as community health providers,” said Brahim Ardolic, MD, Executive Director, Staten Island University Hospital.
"NewYork-Presbyterian/Weill Cornell Medical Center is committed to the safety of our patients, and we look forward to partnering with the New York City Department of Health and Mental Hygiene on the continuing effort to combat the ongoing opioid epidemic,” said Dr. Rahul Sharma, Emergency Physician-in-Chief at NewYork-Presbyterian/Weill Cornell Medical Center and Chairman of the Department of Emergency Medicine at Weill Cornell Medicine. “Emergency medicine care providers are on the front lines of treating those impacted by opioid addiction, and the City’s non-fatal overdose guidance will help standardize treatment protocols.”
“As the first hospital in the city to work with the Health Department’s Relay program, which sends peer advocates to meet with opioid overdose survivors at participating emergency departments and connects them to support services, NewYork-Presbyterian/Columbia University Irving Medical Center is proud to expand on our efforts to reduce the risk of future overdose deaths,” said Dr. Angela Mills, Chief of Emergency Medicine at NewYork-Presbyterian/Columbia University Irving Medical Center and Chair of the Department of Emergency Medicine at Columbia University Vagelos College of Physicians and Surgeons. “These guidelines are an important new tool to further educate our staff and make it as easy as possible to help patients get the lifesaving services they need.”
In New York City, someone dies of a drug overdose every six hours. In 2017, there were 1,487 confirmed overdose deaths (PDF). Opioids were involved in 82% of New York City overdose deaths last year, and the powerful synthetic opioid fentanyl was the most common drug, involved in 57% of deaths. From January to September 2018, there were 1,055 confirmed overdose deaths (PDF). Drug overdose death remains at epidemic levels in New York City as illicitly manufactured fentanyl continued to be present in the drug supply. Fentanyl has been found in heroin, cocaine, methamphetamine, and ketamine, as well as in benzodiazepines and opioid painkillers acquired from non-pharmaceutical sources.
Opioid overdose deaths are preventable, and naloxone is available to all New Yorkers who need it. All major chain pharmacies (Walgreens, Duane Reade, Rite Aid and CVS) and nearly 500 independent pharmacies in New York City now offer naloxone without a patient-specific prescription. In addition to access through pharmacies citywide, naloxone is available for free from registered Opioid Overdose Prevention programs, including syringe service programs. Additionally, New York State will cover co-payments of up to $40. The Health Department also offers regular naloxone trainings at its main office in Queens and Tremont Neighborhood Action Center in the Bronx; trainings teach New Yorkers to recognize the signs of an overdose and respond by calling 911 and administering naloxone. The trainings are free, and all participants are offered a free naloxone kit.
Treatment with methadone or buprenorphine is highly effective for opioid addiction and can reduce the risk of overdose. Individuals seeking support or treatment for substance use issues for themselves or their loved ones can contact NYC Well by calling 1-888-NYC-WELL, texting “WELL” to 65173 or going to nyc.gov/nycwell. Free, confidential support is available at any hour of the day in over 200 languages.
If you witness an overdose, call 911 immediately.
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MEDIA CONTACT: Patrick Gallahue/Stephanie Buhle: (347) 396-4177 PressOffice@health.nyc.gov