START Unit offered at MultiCare Good Samaritan Hospital

Provides 3-5 days of medical stabilization/withdrawal management, followed by intensive inpatient treatment for up to 26 total days of admission. This treatment program includes:

• 1:1 time with counselor, group educational and recovery activities — using trauma-informed approaches
• Engage with 12-step recovery concepts
• Care coordination and customized care plan development
• Educational and recovery resource connections
• Medications for addiction treatment
• Pregnancy-specific addiction consultation
• Recreational activities – (walks, crafts, gentle exercise, mindful activities like coloring)
• Prenatal care and connection to community OB providers

While working with the inpatient and group-based treatment, patients also get case management, referrals and coordination with community resources are also provided. Group treatment focuses on a variety of topics, including, physical and psychological trauma, HIV and other risk education, substance education, early parenting, and stress management in recovery, early recovery, mindfulness, relapse prevention. Medication-Assisted Treatment uses evidence-based medications for withdrawal management and treatment of substance use disorders. Medications are adjusted and stabilized during admission, and clients are provided links to outpatient providers to continue medication treatment after discharge. This unit provides both methadone and buprenorphine treatment for opioid use disorder. Patients can also access 24-hour nursing care, routine medical and obstetric care, and immediate access to obstetric emergency services on campus. Services provided include:

• Obstetric lab testing and imaging
• Daily medical care during stabilization, then regular weekly medical care
• Antenatal testing as indicated
• Screening for and management of common mental health conditions such as anxiety and depression
• Medication management
• Nursing, medical, and obstetric education
• Parenting and Childbirth Education.

Includes education around prenatal care, childbirth, postpartum care, newborn/early infancy parenting, engaging with the healthcare system, self-advocacy, coping skills, and pain/symptom management options. During the stay, the counseling team works diligently to secure sober housing whenever possible and further treatment for all patients after their inpatient stay. If patients are returning to friends or family, a family session with a recovery plan for post discharge is initiated to ensure clear communication and expectations. Many patients choose to continue on to long-term treatment, and the team initiates the process while they are in treatment on the unit. Refers to community resources, such as the Parent Child Assistance Project, public health, OBGYNs, intensive outpatient, inpatient, mental health agencies, DSHS, as needed and where possible.

Washington 211