Scott Simpson, MD, MPH, is an emergency psychiatrist at Denver Health Medical Center and an associate professor of psychiatry in the University of Colorado School of Medicine. Several years ago, he and his colleagues were working with the Denver Police Department to expand the use of suboxone treatment for individuals with opioid use disorder.
“We had all these ideas about providers going out with police to do suboxone treatment,” said Simpson. “We had a meeting with the Chief of Police. He asked us, ‘We are doing great on opioids, what do you have for meth?’”
That moment was the catalyst for BEAT Meth, a comprehensive systems-level intervention for methamphetamine addiction. Denver Health is a longtime hospital partner to the Colorado Clinical and Translational Sciences Institute (CCTSI). Methamphetamine is the second leading cause of overdose death in America after opioids. The name BEAT Meth is short for Beginning Early and Assertive Treatment for Methamphetamine Use Disorder.
Simpson is co-principal investigator of BEAT Meth along with Deborah Rinehart, PhD, associate professor of medicine and Alia Al-Tayyib, PhD, MSPH, clinical professor in the Colorado School of Public Health. The grant is funded by the Centers for Disease Control and Prevention to address methamphetamine overdose. And though many patients do not engage in treatment, Simpson said his team is already making strides.
- The team convened an international expert panel to define the diagnostic criteria for methamphetamine-induced psychosis which, up to now, did not exist.
- Program leaders are training Denver Health staff on available methamphetamine treatments and the neurobiology of addiction. They have developed treatment pathways and processes to improve entry into care.
- The grant includes a randomized control trial, which is testing a navigator intervention to engage and keep individuals in treatment. Partnering with Denver CARES (Denver Health’s withdrawal management and residential treatment program) and inpatient and emergency psychiatric services at Denver Health, they are currently recruiting study participants.
- The BEAT Meth team is also examining electronic medical records to better understand how providers code for methamphetamine use to inform how to identify this patient population in the health system.
Rinehart acknowledges it is essential to improve the way health care systems identify patients who may have a methamphetamine use disorder.
“The ICD10s [diagnostic codes] are not specific to methamphetamine,” said Rinehart. “We are exploring different ways to identify who is experiencing methamphetamine use disorder so we can better understand the prevalence, what happens to them and if they are engaged in services and treatment.”
Al-Tayyib recently led a project focused on enhancing engagement and retention in care for opioid use disorder. She and her colleagues believe they can apply some of the strategies from opioid use disorder treatment to help those addicted to methamphetamine.
“We learned that having a dedicated care navigator increased retention in care among those in treatment for opioid use disorder two-fold compared to those in usual care. These findings are promising for a similar intervention to link and engage people in care for methamphetamine use disorder,” Al-Tayyib said.
This year, Simpson and colleagues published results from the pilot study in the Journal of Addiction Medicine, which showed that BEAT Meth patients were nearly 3 times more likely to attend an outpatient specialty addiction appointment in the 30 days after discharge than comparison patients. Subsequent Emergency Department (ED) utilization was common among all patients, and there was no significant difference in 30-day ED return rates between BEAT Meth and comparison patients.
The team is now providing training to hospital staff. They share the lessons of BEAT Meth with clinical teams and want to help hospital staff translate these findings into practice. Their presentations include testimonials from individuals in recovery, who share their stories. The BEAT Meth team is also looking at starting to provide community presentations to help others better understand what methamphetamine addiction treatment looks like and how to talk to someone in recovery.
“We have learned that treatment for methamphetamine use disorder can work. We can get patients into treatment, but our providers and staff need to offer it and know how to help patients get started in treatment,” Simpson said.