What role can hospital medicine physicians play in treating patients with opioid use disorder?

Opioid use disorder is a common comorbidity in hospitalized patients, but may pose a challenge to hospital-based providers who often care for patients with this chronic conditions only for a few days. Recent evidence suggests, however, that hospitalists can play an important role in helping these patients with their addiction problems.  A study that implemented screening, brief intervention, and referral to treatment (SBIRT) in hospital settings concluded that illicit drug use decreased by 67.7% at 6 months in patients who underwent such intervention (1). Opioid substitution therapy may also be an option in hospitalized patients. A randomized-controlled trial of patients who underwent hospital-initiated buprenorphine/naloxone therapy followed by referral to primary care providers found a 41% increase in patient engagement with addiction treatment at 30 days in the intervention group compared to the group that received only referral for treatment (2).

1. Madras B, Compton W, Avula D, et al. Screening, brief interventions, referral to treatment (SBIRT) for illicit drug and alcohol use at multiple healthcare sites: comparison at intake and 6 months later. Drug Alcohol Depend. 2009;99:280-295.

2. D’Onofrio G, O’Connor P, Pantalon M, et al. Emergency department-initiated buprenorphine/naloxone treatment for opioid dependence: a randomized clinical trial. JAMA 2015;313:1636-44.

 

Contributed by Ethan Balgley, Harvard Medical Student

What role can hospital medicine physicians play in treating patients with opioid use disorder?

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s