Identification and Treatment of Opioid Withdrawal and Opioid Use Disorder in the Emergency Department

Abstract

Introduction: Opioid addiction and misuse constitute a public health crisis in the United States. Recent research supports buprenorphine induction in the emergency department (ED) setting for patients with opioid use disorder (OUD). However, education regarding buprenorphine induction for emergency medicine (EM) physicians, residents, and students is still limited. Methods: We created a 1-hour introductory workshop for the identification and treatment of opioid withdrawal and OUD in the ED for medical students going into EM and for EM interns. The workshop consisted to two distinct curricular sections: (1) a didactic session providing an overview of the basic knowledge and skills to identify and treat patients with OUD in the ED and (2) a case-based session in which students worked through the identification of opioid withdrawal; discussion of opioid use with the patient, going through the steps of SBIRT (screening, brief intervention, and referral to treatment); and considerations when starting buprenorphine. The workshop was evaluated using a pre-and posttest examining medical knowledge around buprenorphine use in the ED. Results: A total of 48 students and interns participated in the curriculum. The students showed a significant improvement in medical knowledge between the pre-and posttests, with an average 45% higher score on the posttest (p < .001). Discussion: Our workshop resulted in a short-term improvement in medical students' and interns' knowledge of the identification and treatment of patients with OUD in the ED.

Medical Student Screening for Naloxone Eligibility in the Emergency Department: A Value-Added Role to Fight the Opioid Epidemic

“…[18][19][20] While curricular initiatives focused on opioid use disorder are growing in number, we are not aware of any other curriculum that offers teaching on OEND with a direct application of learning in the clinical environment. [21][22][23][24] This novelty of our curriculum provides an engaging learning experience and a real impact for the clinical team.…”

Treating Withdrawal and Pain in Inpatients With Opioid Use Disorder: A Brief Educational Intervention for Internal Medicine Residents

“…In one survey, 77% of residency program directors reported that residents frequently cared for patients with OUD, yet only 23% reported spending 12 or more hours of curricular time on addiction. 8 Furthermore, most prior educational interventions on OAT are based in outpatient settings [9][10][11] or the emergency department 12 rather than the inpatient setting. There have been no prior studies of educational interventions aimed at broadly teaching all IM residents within a program to manage OAT in the inpatient setting.…”

A Multi-Modal Curriculum Teaching Opioid Use Disorder Management in Young Adult Populations

“…Didactic and skills sessions for internal medicine, family medicine, and emergency medicine residents have shown that specific training, such as naloxone training, is effective in improving overall comfort in caring for adults with opioid use disorder and change in clinical practice [13][14][15][16]. Given the success of dedicated curricula for trainees of other specialties regarding adult opioid use disorder, we developed a clinically translatable curriculum for pediatric and family medicine residents to specifically identify and treat AYA opioid dependence and withdrawal in pediatric patients, with hopes of improving resident comfort treating opioid use disorder and addiction in clinical practice.…”