Health group gets $4.7 mil­lion to fight ad­dic­tion

Con­necti­cut also has one of the high­est rates of adult binge drink­ing in the United States.

The Norwalk Hour - - FRONT PAGE - By Rob Ryser

DAN­BURY — It would be hard to find a doc­tor’s of­fice where wait­ing room pa­tients aren’t asked to in­di­cate on med­i­cal his­tory forms whether they smoke.

Soon, it may be hard to find a doc­tor’s of­fice where pa­tients aren’t asked sim­i­lar ques­tions about their drink­ing and drug­ging habits.

In the mean­time, the health net­work that runs Dan­bury and Norwalk hos­pi­tals is putting a plan in place to not only make al­co­hol and il­licit drug ques­tions stan­dard on med­i­cal his­tory forms, but to have more sub­stance abuse ex­perts on hand to fol­low up with pa­tients whose an­swers in­di­cate they may need help.

The West­ern Con­necti­cut Health Net­work will use a re­cently announced $4.7 mil­lion fed­eral grant to ex­pand its screen­ing-and-in­ter­ven­tion pro­ce­dure for al­co­hol and drugs at 10 of the net­work’s busiest med­i­cal group lo­ca­tions.

“This is an in­no­va­tive ap­proach in Con­necti­cut to in­te­grate be­hav­ioral health and pri­mary care,” said Dr. Kather­ine Michael, med­i­cal di­rec­tor of com­mu­nity health for the West­ern Con­necti­cut Health Net­work.

The health net­work’s 10-site plan may be in­no­va­tive, but the screen­ing-and-in­ter­ven­tion pro­ce­dure it’s us­ing is not. The pro­ce­dure is high­lighted as a key in­ter­ven­tion strat­egy for schools in the 2017 re­port of the Pres­i­dent’s Com­mis­sion on Combating Drug Ad­dic­tion and the Opi­oid Cri­sis.

The goal is to help physi­cians iden­tify and treat sub­stance abuse early in the ad­dic­tion cy­cle, when the dis­ease is eas­i­est to bat­tle.

The opi­oid cri­sis is acute in greater Dan­bury and across Con­necti­cut, which has one of the high­est rates of opi­oid-re­lated over­dose deaths in the coun­try. Con­necti­cut also has one of the high­est rates of adult binge drink­ing in the United States, ac­cord­ing to the fed­eral Cen­ter for Dis­ease Con­trol and Preven­tion.

A “binge” is de­fined as five or more drinks in one sit­ting for a man, and four or more drinks in one sit­ting for a woman.

Greater Dan­bury physi­cians hear the sto­ries in their ex­am­i­na­tion rooms ev­ery day.

“It’s not un­com­mon in doc­tors’ of­fices to hear peo­ple come in and say things like “My job is so stress­ful,’ or ‘I worry about los­ing my job,’ and they fall down that slip­pery slope,” said Dr. Cor­nelius Fer­reira, se­nior med­i­cal di­rec­tor for the West­ern Con­necti­cut

Med­i­cal Group. “In­stead of coun­sel­ing, they start on this process of self-med­i­ca­tion.”

The health net­work has been prac­tic­ing the screen­ing-and-in­ter­ven­tion pro­ce­dure on a lim­ited scale for the past three years.

With the grant money, WCHN will hire three more be­hav­ioral health con­sul­tants to be on hand in the event a pa­tient is deemed to be at risk for al­co­hol or drug abuse.

In ad­di­tion to Dan­bury, the pro­ce­dure will be rolled out at nine other med­i­cal group sites in­clud­ing Brook­field, Ridge­field, New Fair­field, New­town, South­bury, and Wil­ton.

The pro­ce­dure re­flects the grow­ing un­der­stand­ing in the be­hav­ioral health sciences about how ad­dic­tion is best treated.

For ex­am­ple, med­i­cal his­tory ques­tions about al­co­hol and drug use are phrased with the un­der­stand­ing that a pa­tient might not want to an­swer them truth­fully.

“We have done this with ques­tion­naires to screen for de­pres­sion and anx­i­ety where there also ma1y be some re­sis­tance to an­swer truth­fully,” Fer­reira said. “Some­times the fam­ily will come in with the pa­tient and say, ‘You know, the last time you didn’t fill this out hon­estly.’ ”

In the same way, the ap­proach that be­hav­ioral health in­ter­ven­tion­ists take is dif­fer­ent than the con­fronta­tional ap­proach that may have been used in the past.

“We use mo­ti­va­tional in­ter­view­ing tech­niques rather than the old style of telling the pa­tient ‘If you don’t stop do­ing this you are go­ing to die’ – that doesn’t work,” Michael said. “We try to rally the pa­tient around a com­mon goal, ask what he or she would like to change, and come up with a plan to make that change.”

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