Opioid Testimony – Corina Freitas MD, MSc, MBA (eVitals)


Councilmembers Allen and Gray,

My name is Corina Freitas and I am DATA2000 certified Family Physician and Psychiatrist in-training. Currently, I train at the DC Department of Behavioral Health and provide care for our citizens at the 35k street clinic, as well as at DBH’s Comprehensive Psychiatric Emergency Program. I come to you today representing the Committee of Interns and Residents to show support for Bill 22-0458 and Bill 22-0459. While we think these two bills would open significant doors to our patients and we support all the points; we would like to draw your attention to some issues that may be addressed by these bills, albeit with a few modifications.

As it pertains to the Opioid Prevention Act: several other professionals, besides MPD, are on the front lines in the war with opioid addiction and deaths: Homeless Outreach Program, Mobile Crisis, Assertive Community Treatment Teams, Parole and Probation officers, as well as Shelter and Crisis Bed personnel. These individuals, sometimes more likely to be confronted with patients with an opioid overdose than MPDs are, should also be armed with opioid antagonist rescue kits.

As it pertains to the Opioid Abuse Treatment Act, I will focus on the points we find most important due to the time constraint, however if more feedback is welcomed, I would be happy to do so at the request of the council.

First, the point: requiring high-rate opioid prescribers to participate in training – defining “high rate” prescribers could become quite a feat and how would one enforce training for only a subset of people? Our suggestion is to request boards to attach opioid and MAT training to CME requirements, just like HIV is now.

Second, requiring the Department of Corrections’ Medical Director to have experience with opioid treatment is a good idea in theory, however the Medical Director would seldom, if at all, be involved in actual prescribing; in such cases, we would suggest requiring all DOC prescribers (NPs, PAs, MDs) to be certified, as a contingency of their employment.

Third, is addressing the requirement that hospitals establish discharge protocols for individuals identified as having a substance abuse disorder. Protocols already exist such as giving out APRA info or directing a patient towards a clinic. However, this does not ensure nor constitute proper follow up; and sometimes it is not practically feasible for a clinic to accept more patients. Thus, we suggest requiring hospitals to ensure proper follow-up post discharge, by making an appointment for the interested patient prior to leaving.