After 16 years of addiction that started with pain medication, Thomas McCarthy had enough and went to the emergency room.
"They said I wasn't sick enough, to come back tomorrow," he said. "By then, you don't want to come back by then. You're just going to find something out on the street to kill the dope sick."
"Dope sick" is a term to describe severe symptoms of withdrawal, including shakes, sweats, hallucinations and pain. "I felt betrayed by the hospital. I was left on a gurney for six hours," McCarthy said.
"We're not necessarily the environment for treatment to be started in," said Dr. Timothy Lum, who is Chief of Emergency Medicine at Highland Hospital. That is not the hospital involved with McCarthy's case.
However, Dr. Lum provided some perspective: He says ER's are not equipped to prescribe withdrawal medications such as suboxone, which require doctors to have a special license.
"The emergency department is open 24/7," said Lum. "We need someone we can call in at 4:00 in the morning," he said.
"It was a spot where patients used to fall through the cracks at times," said Dr. Holly Russell, a primary care physician. "We want to meet people where they are. When they ask for help, we need to offer it at that time."
Since spring, Dr. Russell is one of five physicians who rotate on-call. They're available to provide suboxone for someone who comes into the ER wanting help. "They'll actually page us, and we'll go through the criteria to make sure it's appropriate, and we can electronically prescribe the drug," she said.
For the last week, McCarthy has taken a third of a strip of the medication three times a day, allowing it to dissolve under his tongue. It has been a life changer. "It worked in 15 minutes," he said. "It was like a miracle drug. I'm getting emotional now because it saved my life," he said. With the ability to focus, he is now looking into treatment programs.
McCarthy is referring to deadly fentanyl. Nearly all heroin sold on the streets here contains fentanyl. The medical examiner said it is responsible for nine of every 10 opioid deaths in Monroe County last year.
Highland's bridge program closes the gap between the ER and treatment. Rochester Regional Health has a similar program which has already referred 56 people to treatment programs. "We're well aware of where we sit in the cross-hairs of the opioid crisis," said Dr. Lum. "The question is what part of the solution can we be?"