Wolf's care extends beyond the walls of St. Francis' emergency department

Photos | Contributed Dr. Wolf has helped oversee a Suboxone program at St. Francis Hospital and Medical Center, which is a medication-assisted treatment program for addicts.

Dr. C. Steven Wolf chairs the emergency department at St. Francis Hospital.

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By John Stearns

Category: Advancements in Healthcare — Prevention

Dr. C. Steven Wolf

Employer: St. Francis Hospital and Medical Center

Title: Chairman

Department: Emergency Medicine

Dr. C. Steven Wolf has seen his share of drug addicts visit the emergency department (ED) at St. Francis Hospital and Medical Center, where he is chairman of the Department of Emergency Medicine.

In addition to helping patients at the moment, he wanted to do more to wean them off the toxic grip of whatever narcotic consumed them.

“We're trying to keep people safe and unfortunately, a lot of times, people just refuse to keep themselves safe,” Wolf said. “So that we can look at ourselves in the mirror, we need to try to prevent injury, prevent harm.”

Seeking to help addicts who didn't want to be admitted or checked in to St. Francis' inpatient addiction ward, but still needed help kicking their drug habit, he and his staff sought and won a state grant for a Suboxone induction program at St. Francis that began last December.

“The whole Suboxone program and process gives us the ability to actually do some good on our own turf” in the ED for people who want to be helped, but don't necessarily want to go upstairs to the ICU or to the inpatient psychiatric area, he said. The medication-assisted treatment program begins at St. Francis, which coordinates with outside agencies to hand off the patient for continued treatment and counseling.

And for the overdose patients who had to be rescued by Narcan but who maybe don't want treatment at that moment, St. Francis, with its Suboxone program, can “try to convince them that there's another way to keep them safe,” Wolf said. “Our goal is harm reduction.”

That's a common theme with Wolf, who's been at St. Francis since 2003 and in his current role since 2005. Before that, he was in the same position at New Britain General Hospital, now the Hospital of Central Connecticut.

His prevention work includes advocating for ways to reduce underage drinking at Xfinity Theatre concerts; serving on a state advisory committee promoting teen safe driving; connecting patients in the ED to services that may not be medical, such as homelessness, but affect their health; and going on Hartford SWAT team calls to provide medical assistance if needed.

“I'm not first through the door,” he said of his SWAT role. “I go after the scene is relatively safe.”

That role typically involves helping suspects or family experiencing chest pain or other reactions, but he's also there to address gunshot wounds if, “God, forbid,” that were to happen.

Patti LaMonica, a registered nurse and executive director of emergency medicine and pre-hospital service line at St. Francis, said Wolf's integrity stands out.

“He's sort of like the old-fashioned doctor who takes the oath and he's here to do good and to help patients and he doesn't get caught up in much of anything else other than what is the right thing to do for this person, or this family,” LaMonica said. “I like that.”

That's apparent in his work, LaMonica said, with drug addicts and on Hartford's Community Care Team, a group he co-chairs comprising various agencies and providers, including those addressing mental health and homelessness. He seeks a continuity of care for patients, she said.

Group effort

For people who end up in the ED, where they may be frequent visitors, Wolf and the care team, which meets every two weeks, will discuss — with a patient's consent — ways to address the patient's broader needs and build them care plans, perhaps connecting them with a housing provider. Care plans are available to the ED if the patient returns, providing a fuller picture for providers to help patients.

“We really try to take care of soup to nuts, the housing to medical,” Wolf said.

The same advocacy approach applies to people trying to break an addiction. When someone arrives at the ED, Wolf can administer Suboxone, which has similar properties of a narcotic, but prevents withdrawal, keeps patients even-keeled and allows them to function normally, including holding a job.

The Suboxone program also includes arranging for the patient to visit an outpatient clinic and see a Connecticut Community for Addiction Recovery (CCAR) coach who will visit the patient, establish a connection and follow that patient's recovery. Patients then continue Suboxone prescriptions for six months or longer as they “reboot” their brains, Wolf said.

Wolf praises the talented ED team for its frontline work, allowing him “wiggle room” to work on the prevention projects.

“It's a group effort — our crisis workers, our nurses, our physicians — everybody is part of this,” he said.

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