Why consider hospitalization a “reachable moment”? Patients with OUD are often hospitalized for extended periods of time due to discharge challenges (e.g., skilled nursing facilities may not accept patients with substance use disorders) or severe morbidity (e.g., recovering from cardiac surgery for endocarditis). Our team recently conducted a systematic review of hospital-based interventions for patients with OUD. Many interventions used interdisciplinary or multidisciplinary teams that variously included peers with lived experience, social workers, registered nurses, psychiatrists, and internal medicine as well as addiction medicine physicians. As expected, interventions generally focused on linkage to medication for OUD like buprenorphine or methadone during hospitalization and connection to post-discharge OUD care. Results were mixed regarding the impact of existing interventions on outcomes such as improving rates of in-hospital initiation of and post-discharge connection to medication for OUD and decreasing rates of health care utilization and discharge against medical advice. Interventions with the best evidence for improving outcomes facilitated connection to post-discharge OUD care and employed an Addiction Medicine Consult service. The review highlights the need for OUD-related interventions for hospitalized patients with OUD, though existing interventions may need to be adapted or refined to ensure that they are equitably improving meaningful outcomes.
The paper, Interventions for hospitalized medical and surgical patients with opioid use disorder: A systematic review, was published in Substance Abuse on July 21, 2021. Authors include Rachel French, Shoshana Aronowitz, J. Margo Brooks Carthon, Heath D. Schmidt and Peggy Compton.