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Thank you to the New York American College of Emergency Physicians (NYACEP) for featuring the MATTERS Network in your February 2023 newsletter!

Click here to access the full newsletter.

Joshua Lynch, DO FACEP

Chief Medical Officer, MATTERS Network

Interviewee

Jennifer Pugh, MD MBA FACEP

Associate Chief of Service, Erie County Medical Center

Interviewer

I [Dr. Jennifer Pugh] had the honor of interviewing my colleague Joshua Lynch, DO FACEP who founded the MATTERS Network in 2018 to help address the opioid crisis in New York State. Dr. Lynch serves as an Associate Professor of Addiction and Emergency Medicine at the Jacobs School of Medicine and practices in Buffalo, New York. The program has continued to expand throughout New York and neighboring states in 2023.

In January, 2023, the Mainstreaming Addiction Treatment (MAT) Act was signed into law by President Biden and eliminates the X waiver. In addition, this bill removes the limitations on the number of patients a provider could treat with buprenorphine/naloxone at any time. This makes it easier for all emergency medicine physicians to initiate treatment of patients with opioid use disorder, especially those who present to the Emergency Department (ED) in acute withdrawal.

Why did you start the MATTERS Program?

Working as an emergency physician, caring for patients with addiction and mental health issues is part of our job every day. Unfortunately, these diseases often don’t have a clear treatment path. For a patient with chest pain, the assessment and treatment process is usually straightforward. For patients with opioid use disorder, the treatment plan is often challenging. Working through a patient’s varying levels of motivation, finding appropriate treatments in the ED and linking patients to a rock-solid follow up appointment are usually all complicated. Addiction is often a disease process that has been placed on the back burner. This is exactly why we started MATTERS. Finding community treatment organizations willing to take patients as they are was surprisingly easy! Leveraging these partnerships is what led to the MATTERS Network being available across New York State.

What is the MATTERS Network?

The MATTERS Network is collection of resources to initiate care, increase access to buprenorphine and officially link patients to appropriate treatment at community-based organizations through an electronic platform. We currently have 185 clinics we can refer patients to across New York State so they can find help closest to their home. We are also linked with over 1,000 pharmacies. Patients can receive medication vouchers that cover up to a 14-day supply of buprenorphine prescriptions for uninsured patients. Patients can also be offered transportation to and from their first clinic appointment through our partnership with Uber Health. They also have the option to be linked with local peer support.

What are the goals of the MATTERS Network?

Our initial concept was simple. The first goal was to reduce unnecessary controlled substance prescribing in the ED. We would provide access to medication assisted treatment in the ED in hospital settings. At discharge, we would provide rapid access to follow-up with a substance use disorder treatment facility.

Where does funding for this program come from?

We have worked hard to obtain outside funding for this program. We currently receive support from: New York State Office of Addiction Services and Supports, John R. Oishei Foundation, Erie County Department of Health, New York State Department of Health, Substance Abuse and Mental Health Services Administration, NIH HEAL Initiative: HEALing Communities study and the Bureau of Justice Assistance: US Department of Justice.

How does telemedicine play a role in opioid addiction treatment?

The MATTERS Network is partnered with two virtual EDs to streamline rapid access to care for patients experiencing opioid and substance use disorders. Through this partnership, patients can be evaluated, treated and then connected to an outpatient treatment organization across New York State. Patients can request an appointment through our website. I would urge any physicians who may feel uncomfortable initiating medication assisted treatment to inform patients of this option if they feel they may benefit from buprenorphine/naloxone therapy. Our website also offers “Resources by Region” at www.mattersnetwork.org/get-help.

How does a hospital or first responder agency join the Network?

It is very easy! Just visit our website and fill out the contact us form. In most cases we can onboard a new hospital in a few days. You can also download the free MATTERS app from the Apple App store or Google Play!

What other initiatives has the MATTERS Network supported?

Patients can request free fentanyl test strips and become proficient with their use through our user guide. Patients can also receive Narcan and participate in the New York State syringe exchange programs. We have also worked to inform the community of new dangers including Xylazine, an animal tranquilizer that increases risk for opioid overdoses and cannot be reversed with Naloxone.

What information should I be providing to patients?

We have created several resource documents for patients, first responders and health care professionals. Some examples are shown below.

Additional prescriber information can be found on the ACEP BUPE website https://www.acep.org/patient-care/bupe/ and emPOC app available exclusively to ACEP members.