Treatment in Emergency Department Settings

The Treatment in Emergency Department Settings Knowledge Lab highlighted state policy and legislative activities related to the Model Substance Use Disorder Treatment In Emergency Settings Act.

Background Discussion

Learn more from experts about mechanisms for maximizing emergency medical settings as intervention points for people who experience a substance use-related emergency, people with substance use disorders, and their families.

Live Discussion

The live discussion took place on November 13, 2023 at 2:00 pm ET.

Supporting Materials

The Model Substance Use Disorder Treatment In Emergency Settings Act establishes and aligns mechanisms for maximizing emergency medical settings as intervention points for people who experience a substance use-related emergency, people with substance use disorders, and their families. This Act, developed in collaboration with the O’Neill Institute for National and Global Health Law at Georgetown University, intends to do so by addressing the barriers to implementing protocols in emergency medical settings that would ensure evidence-based treatment of patients with substance use-related emergencies. The Act also intends to address barriers to expedited connection to the appropriate level of care following discharge, and incorporates best practices and promising innovations from interdisciplinary research analyzing protocols for emergency medical care delivery for the people most at risk of dying after emergency room discharge. Click here, to read the full text of the Model Substance Use Disorder Treatment in Emergency Settings Act.

Click here to learn more about substance use disorder (SUD) treatment in emergency departments, including a map of jurisdictions that encourage emergency department (ED)-initiated interventions for SUD by having statewide laws that require EDs to either establish specific discharge protocols for patients treated for substance use-related emergencies or initiate medication for addiction treatment for those patients, where clinically appropriate.

Featured Experts

Project Director, Addiction and Public Policy Initiative at the O’Neill Institute for National and Global Health at Georgetown Law

Vice President Ascension Recovery Services

Emergency Physician/Addiction Specialist, Presbyterian Health System, Regional Medical Director, Cenikor

Founder & CEO, Emergency and Addiction MD, CEO, Medical Director
The Reach Project, Inc.

Brandon George

Brandon George is Currently Vice President at Ascension Recovery Services. Prior to joining Ascension RS, Brandon served as the Vice President for Recovery and Advocacy Programs for Mental Health America Indiana and the Director of Indiana Addiction Issues Coalition, which advocates for recovery through public policy and education. Brandon has consulted throughout the country on both policy and recovery infrastructure. His effort around increasing access to medications for opioid use disorder has been acknowledged widely having contributed to Johns Hopkins School of Public Health’s publication on this topic and Georgetown Law O’Neill Institute’s toolkit on MOUD in corrections.

Brandon has been a consultant for SAMHSA’s Opioid Response Network, the Bureau of Justice Assistance, and is a contributor to Harvard’s Law Blog. He served as a trusted advisor to the National Judicial Opioid Task Force, on the leader’s council for Legal Services Corporation (LSC) and worked with the White House for the Office of National Drug Control Policy to create model law. Brandon graduated with a Bachelor's degree in Addictions Counseling from Indiana Weslyn University and lives in Noblesville, Indiana with his family.

In 2023, Brandon received the Sagamore of the Wabash award which is one of the highest honors in the State of Indiana given by the Governor. The title is awarded to those who have made a significant impact to Indiana life: Past recipients have included astronauts (Gus Grissom), athletes (Michael Brinegar, Ray LeBlanc), comedians (David Letterman), musicians (Willie Nelson), and president (George H. W. Bush).

Eric Ketcham MD, MBA, FACEP, FASAM, FACHE, FAAEM

Dr. Ketcham is board certified in both emergency medicine (ABEM) and addiction medicine (ABPM). He works as an EM physician in Santa Fe and Espanola, NM for the Presbyterian Healthcare system (PHS). He works clinically as an addiction specialist at Presbyterian Espanola Hospital, where he sees patients in substance use disorder (SUD) clinic, and as an addiction medicine consultant (in ICU, PCU, ED, L&D, etc.). He serves as a clinical expert for several SUD treatment projects for PHS for the treatment of alcohol use disorder (AUD) and opioid use disorder (OUD). Dr. Ketcham also serves as the medical director for a medical detox and residential treatment center, Cenikor Foundation, in Farmington, NM, and served as the medical director of a methadone clinic (OTP) for nearly 8 years. Dr. Ketcham works with New Mexico Behavioral Health Services Division (NM BHSD) as the Director of Clinical Implementation for the NM Bridge Program, assisting hospitals in the development of OUD treatment programs, and as an on-call addiction expert for the New Mexico Poison Control Center Addiction Helpline. He is the co-founder and a past chair of the Pain Management and Addiction Medicine Section of the American College of Emergency Physicians (ACEP). He is active in both state and federal advocacy. He has testified before the NM Legislature, and he has been called twice to speak as an expert at United States Congressional briefings (2019) and to testify as an expert in addiction and emergency medicine before the US Congress, House Judiciary Committee (2016).

He has been initiating treatment of opioid use disorder (OUD) in the ED with buprenorphine since 2012.

Justine Waldman, MD

Justine Waldman is Board Certified in Addiction Medicine, Emergency Medicine, and a Fellow of the American College of Emergency Physicians. Since December of 2016, she has been providing Low Threshold Medications for Addiction Treatment (MAT), Hepatitis C treatment and acute care to People Who Use Drugs at the Syringe Service Program (SSP) at the Southern Tier Aids Program in Ithaca, NY. She is currently the CEO and CMO of Reach (Respectful, Equitable Access to Compassionate Health) Medical in Ithaca, NY which opened in February of 2018. REACH houses a medical practice offering integrated primary care and low threshold harm reduction services for people who tend to face stigma in the current medical system. Reach Medical offers primary care, MAT, viral screening, vaccination and treatment and on demand behavioral health care. Since the Spring of 2020, REACH has been growing a robust outreach program staffed by individuals with lived experience who offer viral screening, vaccination and treatment, acute primary care and MAT visits via telehealth. In addition, REACH is the administrative home for case management for the Ithaca Law Enforcement Assisted Diversion Program (LEAD).

REACH has an established Peer Advisory Board in which peers are provided stipends through a local foundation grant to advise REACH on various aspects of our organization, e.g., service delivery, and research. REACH has an increasingly renowned Research Department steeped in bringing the REACH model to scale (PEW grant), and studying the outcomes that are being achieved in a rural health equity setting (HRSA grants).

Edwin C. Chapman, MD, DABIM, FASAM

Dr. Edwin C. Chapman has practiced in Washington, DC for over 47 years specializing in Internal Medicine and Addiction Medicine. Over the past 21 years, he has investigated the complex mix of addiction, undertreated mental illness, infectious diseases (AIDS & Hepatitis C), criminal behavior, and chronic diseases in which patients have 20-25 year shorter life expectancies. Dr. Chapman received his B.S. in 1969 and M.D. in 1973 from Howard University College of Medicine. He completed his internship and residency in internal medicine as well as a fellowship in cardiology from historic Freedmen’s and Howard University Hospitals. He is board certified by the American Board of Internal Medicine (ABIM, 1979), the American Society of Addiction Medicine (ASAM grandfathered to ABAM, 2009), a Fellow of the American Society of Addiction Medicine, and a member of Alpha Omega Alpha Honor Medical Society. He maintains active memberships in the National Medical Association (NMA), Medico Chirurgical Society of Washington, DC (MED CHI of DC), the American Medical Association (AMA), the Medical Society of the District of Columbia (MSDC) as well as associate membership in the Black Psychiatrists of America.

Dr. Chapman is a founding member and secretary of the board of directors of the Leadership Council for Healthy Communities (an inter-faith 501(c)3 organization with 30+ Metro DC institutions) where he is bringing integrated medical care into underserved communities and faith institutions (ACA’s “Accountable Health Community”) using both onsite care and virtual care thru tele-video consultation for social work, nutritional consulting, pharmaceutical reconciliation, as well as psychiatry and primary care. Using this urban, collaborative care virtual office telemedicine design, he is addressing the needs of opioid-addicted index patients and their entire families recognizing the impact of addiction as a “social determinant of health” and a factor leading to “toxic stress” in both family and community-wide settings. In 2008, Dr. Chapman was featured in the National Alcohol and Drug Addiction Month DVD entitled “Medication-Assisted Therapies: Providing a Whole-Patient Approach to Treatment” sponsored and produced by the Substance Abuse and Mental Health Services Administration (SAMHSA). He was appointed in January 2019 to the National Academy of Science Engineering and Medicine committee “Examination of the Integration of Opioid and Infectious Diseases Prevention Efforts in Select Programs” and currently collaborates on research protocols with the Howard University School of Pharmacy and College of Medicine.

Dr. Chapman is a widely sought speaker on the impact of historical oppression and anxiety/depression reactive addiction on the African American community and has been featured in The Washington Post, Addiction Professional Magazine, HIT Consultant.com, NPR, EBONY MAGAZINE, Washington WUSA 9, Behavioral Healthcare Magazine, PBS News Hour, The HILL, Canadian Broadcasting Corporation, and international Spanish TV. He was recognized by the National Medical Association as their 2016 “Practitioner of the Year,” Prince George’s County Links, Inc 40th Anniversary 1st awardee for “Excellence in Health and Human Services,” and the Black Mental Health Alliance for Education and Counseling “2019 Phoenix Arising Behavioral Health Provider of the Year Award.”