'Substance use crisis' in Montana: Missoula hospital launches medical detox program

Community Medical Center in Missoula has announced a new medical detox program designed for adult patients who require acute management of withdrawal symptoms from alcohol or opioids.

The need for the service is "urgent," according to hospital CEO Greg Cook, saying there's a substance use crisis in the state.

According to the Montana Substance Use Disorders Task Force, formed by the Department of Health and Human Services, an estimated 79,000 Montanans struggle with addiction. Alcohol is the most common drug of choice.

For people who want to stop drinking, there are physical dangers that come from quitting. For people with a history of high-volume alcohol use, withdrawal can cause seizures, severe vomiting, tremors, hallucinations and sometimes even death. Many people find the withdrawal so physically distressing that they relapse before completing the process without medical management.

That's why Community, starting on July 6, will offer an inpatient, hospital-based withdrawal management program that lasts three to five days. The service will be available through self-referral, and participants will receive round-the-clock monitoring and protocol-specific medications to reduce the severity of withdrawal symptoms.

Cook said there are very few medically-supervised options available in western Montana.

"So, as we look at how we take care of our community, which is our mission, making communities healthier, med detox is one that really stuck out as a community need," Cook said.

He said the hospital's clinical team will approach alcoholism and substance use disorder as a chronic illness, a lot like diabetes or heart disease. Designated nurses and physicians will watch over patients.

A service coordinator will also work with each patient to develop a discharge plan that would include appropriate referrals to the next level of care.

"It's important to me that if a patient comes to the program, that they have that (next level) set up before they're admitted," Cook explained. "Otherwise, it just becomes a revolving door. They come in, they detox, they go home, they relapse. They come in, they detox, and it doesn't do any good. So we want a program where they come in, have a safe place to detox, and then receive treatment after the fact, so they can really turn their life around."

Patients will go through a screening process via telephone to determine if they're a good fit for the program, which will be called StepOne Service.

The hospital will work with Evergreen Healthcare Partners to deliver the detox service. Cook said he's worked with the company in the past.

"We've had in the past huge success," he said. "We've had families get their children back. Just all kinds of very positive things that we've seen from this program, so we're excited about it."

Megan Condra, the director of marketing and community relations at Community, said the only other options in western Montana are all "private pay" models, meaning they don't accept Medicare or Medicaid. Condra said that their program will be covered by most insurance plans currently accepted by Community, and payment plans are available.

She said Evergreen has rate of 80% of patients completing the detox program and continuing on with detox treatment.

Cook said most existing treatment settings in Montana are designed for individuals who have already completed detox. One program that accepts Medicaid and Medicare is located in Billings, which isn't a great option for people on this side of the state. There is also a facility in Spokane, which is about three hours away over a few mountain passes.

Cook said the team at Community is hopeful about making a difference.

"Addiction doesn't discriminate, it touches families at every income level, every age group, every walk of life here in Montana,” Cook said. “What we know is that it is a medical condition that can be treated, and recovery is possible. This program is about making sure that when someone is finally ready to ask for help, we have something to offer them, right here at Community Medical Center.”