Emergency Departments are often the primary source of healthcare for marginalized patients with substance use disorders.1 As such, we have unique opportunities to intervene and initiate change. While many acronyms and screening tools exist to identify substance use disorders, I have yet to find one that helps cover high yield items to be discussed with patients prior to discharge.2 In response, I created a clever, easy to remember tool based on case management practices that I use on every shift to ensure my patients with addictions have been fully cared for.3 My goal is that this will help in your practice as well.
Patients may have a MORPHine or other addiction, and our treatment should involve MORPHing our approach to each patient.
Medical Care– Have I treated all medical needs? Do they need detox vs inpatient care or a specialist referral?
Opinion– Does my patient feel heard?
Relationship Safety- Are they safe at home? Is there suicidal ideation? Is there risk of domestic violence? Are children involved?
Plan in place- What are the next steps? Do they agree? What does their next day/week look like?
Housing– Are basic needs such as housing and food being met?
- 1.Hawk K, D’Onofrio G. Emergency department screening and interventions for substance use disorders. Addict Sci Clin Pract. Published online August 6, 2018. doi:10.1186/s13722-018-0117-1
- 2.Portico. Clinical tools . Portico. Published 2020. Accessed December 23, 2020. https://www.porticonetwork.ca/tools/clinical-tools?fbclid=IwAR0d6Q6xsFCCrl6HEa9ZIdeDVN4bXxHiInzI8lbukLqTSNZJQ62XHeY468A
- 3.Najavits L. Seeking Safety: A Treatment Manual for PTSD and Substance Abuse. The Guilford Press; 2003.