“We are at a critical point in the opioid epidemic,” says Andrew Herring, MD. “In Oakland right now, this is when the greatest number of deaths are occurring because Fentanyl is entering the system. It’s happening now.”
Dr. Herring leads the Bridge Substance Use Clinic at Highland Hospital, where something unusual happens. Patients arrive without appointments and are seen within minutes. The phone rings and a medical assistant answers: “Can you come in now?” he asks. “Do you need an Uber?”
The clinic is set up to be as flexible and patient-friendly as possible. Services are delivered on-demand, in-person, on the phone, and in the field. It’s a novel experience for many substance use patients who are more accustomed to encountering a health care system that is often hostile toward them.
The Bridge Clinic’s delivery of care might raise eyebrows among clinicians who are concerned about high-utilizers. Dr. Herring dismisses that idea.
“The problem is not that they’re over-utilizing. The problem is that they are dying,” he says.
Dr. Herring has been in the news lately for his use of a new drug therapy, extended-release buprenorphine. It works by binding to opioid receptors in the brain and reducing cravings and withdrawal symptoms. Unlike the oral versions that must be taken daily, extended-release buprenorphine is delivered as an injection and works for 30 days.
According to Dr. Herring, the shots’ longer-acting protection is a game-changer for patients who can’t commit to taking medication every day and ultimately fall out of treatment. This is especially true for patients who experience homelessness and other social barriers to consistent treatment. And because buprenorphine occupies opioid receptor sites, it also keeps other opioids from binding. This ensures that if a patient takes a high dose of a drug like heroin or Fentanyl, they are less likely to overdose.
“I know that if they get their injection, they are receiving care for the next month,” says Dr. Herring. “Survival is the goal. I want them to make it to their next appointment.”
Dr. Herring was recently featured in The Los Angeles Times and Kaiser Health News. Read the recent coverage here.
If you or someone you know are struggling with substance use, visit the Alameda County Rapid Access Substance Use Treatment Bridge Clinic website or call 510-545-2765.