River Mend Health is a premier offering of scientifically driven, specialty behavioral health services to those suffering from alcohol and drug dependency, dual disorders, eating disorders, obesity, and chronic pain.
Established on the belief that addiction and obesity are the nation’s most pressing healthcare challenges, the company brings together the world’s preeminent experts and a nationwide network of rehabilitation facilities to conduct evidence-based treatment, research and education.
Through the delivery of world-class, specialty behavioral health treatment, experimentation, and education, River Mend Health seeks to enhance the quality of life of those who seek our help, their loved ones and the communities in which they live.
- Alcohol Use Disorders & Addiction
- Drug Use Disorders & Addiction
- Dual Disorders
- Pain Medication Abuse & Addiction
- Impaired Professionals
- Eating Disorders
- Mindfulness-Based Relapse Prevention
- Recovery Planning and Coaching
- Spiritual Care and Healing
- Expert Medical Management
- Addiction Centered Counseling
- Family Treatment
- 12 Step programs
- Continuous Monitoring
- Private pay
Awesome and caring staff. They helped get me back on the right path. I am forever grateful for this program.
Saved my life. Thank you
Patients will often have a history of multiple overdoses. What is your approach and ideal post-rescue plan? Do you transfer them to a locked unit or give them a follow-up appointment? What happens to a person who is given Narcan and rescued by an EMT?
I tend to be as aggressive and assertive as possible while discussing the severity of the illness and the dire need for intensive treatment, especially in a patient who has had multiple overdoses. I attempt to motivate every patient who has experienced an overdose to be initiated on medication-assisted treatment (MAT). If agreeable, I will start buprenorphine in the VA/Yale psychiatric emergency room. Initiating buprenorphine in an emergency room setting is difficult in practice. Given the resources available at the VA we are able to do it. This practice is based upon a recent study at Yale that showed that initiating buprenorphine in emergency setting results in patients more likely to be connected to treatment. I also educate every patient about the need for a psychosocial support structure. I am a proponent of AA/NA programs and I discuss with all patients the importance of meetings/sponsorship. The goal for all patients who present post overdose is to initiate them on buprenorphine, transfer them to our substance use treatment program (either inpatient or IOP level of care) and then to attend 90 meetings in 90 days.
We generally refer to opioid overdoses as accidental, but do you have an idea of what percentage of the patients are depressed, wanted to die, or had passive suicidal ideation? Do you formally evaluate them for concurrent psychiatric illness at some time after you save their lives?
All patients who present to the psychiatric emergency room receive a thorough psychiatric and substance use assessment. The prevalence of co-occurring psychiatric illness with opioid use disorder (OUD) is very high. By the time the OUD has progressed to the point of intravenous use leading to Narcan reversal, there are typically many psychosocial consequences and stressors. In addition, these patients are often young (<30). These severe consequences, which often occur quickly, may lead to feelings of hopelessness, helplessness and passive suicidal ideation (SI). While I do not know firm percentages, in my experience the majority of those with severe opioid use disorder suffer from comorbid anxiety and/or depression. A lower percentage, but still significant amount, experience passive SI and will report things like “I was not trying to kill myself, but if I were to never wake up the world would be better off without me”. I would say that a small but significant percentage is actively suicidal at the time of the overdose with intent to die.