Reducing Barriers to Substance Use Disorder Treatment Facilities and Programs for Persons with Bleeding Disorders
Publication Date: August 20, 2023
Last Updated: January 19, 2024
Preamble
- MASAC is aware of multiple reports of PwBD being denied access to residential SUD treatment facilities, despite being appropriate for admission.
- Every person, assuming they are medically stable and otherwise appropriate for admission, should have equal access to residential/inpatient SUD treatment facilities, regardless of their inherited bleeding disorder diagnosis, the treatments/medications they use, or state in which they live.
- The role of a comprehensive hemophilia treatment center (HTC) is to provide holistic, individualized patient care, and to support and advocate for PwBD throughout their lifespan. This includes ensuring that the BD and associated treatments are not barriers to a person’s SUD can continue to receive the standard of care for their BD while residing in a SUD treatment facility.
Background on bleeding disorders
- Inheritable BD are lifelong, genetic conditions with no known cure.
- is stable (see section III for definition of stability from a BD perspective) and can maintain their established treatment protocol, having an inheritable bleeding disorder should not preclude a person from receiving SUD treatment in a residential/inpatient setting.
- PwBD who are stable and well-maintained on their medication typically live in the community and do not require any direct medical supervision related to this condition. They typically lead full, active, and independent lives.
- There are no restrictions for activities except participation in contact or collision sports/activities that could result in significant physical injury.
- PwBD managed through prophylaxis
- One subset of PwBD (e.g., some individuals with hemophilia A or B, severe von Willebrand disease, and other rare BD) use BD medication prophylactically to prevent bleeding.
- Depending on the type of medication utilized, they are administered either as an intravenous push or as a subcutaneous injection. Typically, intravenous infusions take approximately 5-10 minutes. Medications delivered subcutaneously can be administered in under one minute.
- For this subset of PwBD, prophylactic treatment is required to ensure stability from a BD perspective.
- PwBD managed through prophylaxis may also require BD medication to treat bleeds in the event of trauma or injury.
- PwBD managed episodically
- Another subset of PwBD (e.g., individuals with moderate or mild hemophilia A or B, or mild or moderate von Willebrand disease, other BD), do not require regular BD medication to maintain stability from a BD perspective and typically only treat in response to trauma or in advance of an invasive medical procedure.
- The BDThe BDThe BD treatment team should be contacted upon admission to advise the facility regarding the PwBD’s individualized care plan while at the facility.
Overview
Title
Reducing Barriers to Substance Use Disorder Treatment Facilities and Programs for Persons with Bleeding Disorders
Authoring Organization
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