Mo. Hospital Opens Drug Rehab Facility for First Responders, Healthcare Workers
Editor's update: Managed Medicaid plans cover the full scope of inpatient services for SSM Health Treatment & Recovery. Patients who have either traditional or managed Medicaid will be admitted for an inpatient stay, with appropriate approvals from managed Medicaid and traditional Medicaid. The program's inpatient care encompasses detox and medical stabilization.
Apr. 9—A mock front door welcomes patients to a staged living room designed to trigger the desire to use alcohol or drugs. Therapists play the role of family members to put people in situations that cause them anxiety.
The therapeutic simulations are part of a new treatment and recovery clinic at SSM Health St. Joseph Hospital-St. Charles that offers inpatient and outpatient treatment for drug and alcohol abuse.
"Addiction is about a loss of control," said Michelle Schafer, SSM Health's network vice president of behavioral health. "If you predict for them what will happen (when they go back to work or home), they feel better prepared instead of being overcome by the anxiety."
The clinic opened late last year and is aimed at working professionals, including health care workers and first responders who want to get sober and get back to their jobs, hospital leaders said. The clinic is believed to be the only one in the state operating inside a full-service hospital.
The St. Louis area has 779 hospital beds for mental health care, but most are not devoted to substance abuse treatment.
"Expanded space with a commitment to addiction and recovery makes a lot of sense in a state with a significant opioid problem," said Dave Dillon, a spokesman for the Missouri Hospital Association.
The opioid crisis was one of the main reasons that SSM Health executives decided more than a year ago to open the clinic. The hospital spent about $100,000 to convert space on its fourth floor, adding a gym, meditation rooms and common living spaces with views of the Missouri River. The rooms each have two hospital beds, with folded blankets and journals as touches to distinguish them from typical patient rooms.
There are 20 beds for inpatient care and an outpatient program that includes group therapy. The hospital setting means doctors and nurses are available around-the-clock, particularly for patients with other health issues, including asthma, diabetes or high blood pressure.
Anthony Bass, a team leader in stabilization services for SSM Health, said that most people stay up to 16 days depending on their insurance coverage, and then transition to the outpatient clinic for an additional four months or longer. The census since the inpatient clinic opened three months ago has been five to eight patients, Bass said.
U.S. businesses are thought to lose billions of dollars each year from low productivity, workplace injuries and absenteeism caused by employees' drug and alcohol use. An average of 9 percent of full-time workers abuse alcohol and/or drugs. For alcohol abuse alone, the mining industry has the highest rate, at 18 percent. For illegal drug use, the hospitality/food services industry has the highest rate, at 19 percent, according to the U.S. Department of Health and Human Services.
Health care workers abuse drugs and alcohol at rates similar to the general population, but are at much higher risk of abusing prescription drugs, including opioid painkillers. Schafer said the hospital is in discussions with the state to become certified to treat doctors and nurses with addiction problems that have led to discipline by their employers or licensing boards.
There are no facilities in the state approved to work with doctors who need drug or alcohol treatment as a condition of keeping their license, according to Robert Bondurant, executive director of the Missouri Physicians Health Program. The program refers doctors to other states if they need inpatient care as a condition of probation, Bondurant said.
Hospital-based rehab centers were common in the 1970s and 1980s before hotel-style, stand-alone facilities became popular, said Howard Weissman, executive director of the St. Louis-based National Council on Alcoholism and Drug Abuse.
There is little research on the advantages of each setting, but any new treatment beds are welcome during what Weissman called "the worst drug epidemic in modern American history." While the reports aren't finalized, an estimated 800 people died from opioid overdoses (heroin and prescription painkillers) in the St. Louis area last year, a record high, he said.
St. Charles County has the state's seventh-highest rate of heroin overdoses, according to the Missouri Department of Health and Senior Services.
The new clinic does not accept Medicaid, government insurance for low-income people. The need for rehabilitation services for poor and uninsured people is highest, Weissman said.
"St. Louis doesn't really need more treatment beds for people with insurance and money," he said.
One St. Charles man started the outpatient group therapy at St. Joseph Health Hospital three weeks ago when he said he lost control of his drinking and smoking marijuana. The man, 26, asked not to be identified because his employer has a strict drug-free policy.
"I never really understood why I was so dependent on substances," he said. "As we talk about the triggers, I learn about myself. I had some underlying stress, anxiety and depression that I had never even paid attention to."
The man, who is single, said he believes his issues stem from his parents' divorce as a child and being left on his own a lot. The instability left him with a fear of abandonment, and he started using drugs and alcohol to self-medicate at age 16. Since starting the program, he said, his parents have noticed he is not so easily frustrated and his thought processes are smoother.
"I've become more mentally healthy through this," he said. "It's more about understanding why you're abusing, what our triggers are and what we can do to avoid it."