CCHPs Identify Barriers to Care, Status of MAT
Our October "Quick Questions" asked CCHPs for their opinions on barriers to care in their facilities and the current status of MAT. Facility leaders and supervisors should be aware of the stress being experienced by the staff to ease burnout and support quality care.
Q1 CCHPs were asked to identify the top three barriers to care in their facilities and to compare them to the barriers they faced before the COVID-19 pandemic began in March 2020.
As in many other fields and industries, staffing is an issue for both health care and custody. Figures do not add to 100% because participants were asked to pick their first, second and third top choices. For each barrier listed, the percent of individuals selecting it grew from pre-pandemic to present day, showing that staffing levels have become more critical. Other options selected for the top challenge included lack of IT (paper records) and lack of support by health care leaders.
While some commented that they didn't face significant challenges, others noted:
- Lack of infirmary housing
- Lack of follow-through by health care staff because of limited hours on-site
- Coordination of systems to improve outcomes and reduce errors
- Lack of continuity in policies and procedures
- Lack of communication
- Rapid increase in patient population
- COVID-19 demands, vaccine mandates, lack of vaccine mandate
- Too many illicit drugs within the jail
- Low pay
- Overwhelming responsibility
- Staff competence
Q2 Participants were asked to indicate their facility's practices for medically supervised withdrawal or detox.
Providing full medically-assisted treatment was the most populat selection as more facilities and medical directors have come to understand the medical needs of individuals with substance use disorder. Only 6% indicated that they have withdrawal without medications. It is difficult to get a full picture with nuance in a multiple choice survey.
- Combo MAT for verified uses, non-opioids for others
- Likely send to local hospital
- Combination of methadone and buprenorphine depending on patient needs
- Individual depending on patient needs
- We work with many systems; some are resistant and staffing is a major hurdle
- Juvenile detention sends juveniles out to a health care facility
Q3 asked those who use full continuing MAT to indicate which medications they use.
Buprenorphine was the most widely used, followed by methadone.
Comments for Other:
- Methadone but only for pregnant patients