The Cost of a Cigarette: Opportunities to Engage Hospitalized Patients With Opioid Use Disorder

Roy, Payel; Saitz, Richard

doi:10.1097/adm.0000000000000681

Cited by 3 publications

(1 citation statement)

References 3 publications

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“…In-hospital substance use policies could facilitate therapeutic responses instead of leaving health care workers to apply potentially stigmatizing beliefs about addiction. 6 , 11 To be effective, these policies must be patient centered, stigma free, evidence-based, nonpunitive, and coupled with addiction education for the health care workforce.…”

Section: In-hospital Substance Usementioning

confidence: 99%

In-hospital Substance Use Policies: An Opportunity to Advance Equity, Reduce Stigma, and Offer Evidence-based Addiction Care

et al. 2022

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In-hospital substance use is common among patients with addiction because of undertreated withdrawal, undertreated pain, negative feelings, and stigma. Health care system responses to in-hospital substance use often perpetuate stigma and criminalization of people with addiction, long etched into our culture by the racist War on Drugs. In this commentary, we describe how our hospital convened an interprofessional workgroup to revise our in-hospital substance use policy. Our updated policy recommends health care workers respond to substance use concerns by offering patients adequate pain control, evidence-based addiction treatment, and supportive services instead of punitive responses. We provide best-practice recommendations for in-hospital substance use policies.

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Section: In-hospital Substance Usementioning

confidence: 99%

In-hospital Substance Use Policies: An Opportunity to Advance Equity, Reduce Stigma, and Offer Evidence-based Addiction Care

et al. 2022

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Opioid Use Disorder Treatment Initiation and Continuation: a Qualitative Study of Patients Who Received Addiction Consultation and Hospital-Based Providers

et al. 2022

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Background Hospitalizations related to opioid use disorder (OUD) are rising. Addiction consultation services (ACS) increasingly provide OUD treatment to hospitalized patients, but barriers to initiating and continuing medications for OUD remain. We examined facilitators and barriers to hospital-based OUD treatment initiation and continuation from the perspective of patients and healthcare workers in the context of an ACS. Methods In this qualitative study, we sought input using key informant interviews and focus groups from patients who received care from an ACS during their hospitalization and from hospitalists, pharmacists, social workers, and nurses who work in the hospital setting. A multidisciplinary team coded and analyzed transcripts using a directed content analysis. Findings We conducted 20 key informant interviews with patients, nine of whom were interviewed following hospital discharge and 12 of whom were interviewed during a rehospitalization. We completed six focus groups and eight key informant interviews with hospitalists and hospital-based medical staff ( n = 62). Emergent themes related to hospital-based OUD treatment included the following: the benefit of an ACS to facilitate OUD treatment engagement; expanded use of methadone or buprenorphine to treat opioid withdrawal; the triad of hospitalization, self-efficacy, and easily accessible, patient-centered treatment motivates change in opioid use; adequate pain control and stabilization of mental health conditions among patients with OUD contributed to opioid agonist therapy (OAT) continuation; and stable housing and social support are prerequisites for OAT uptake and continuation. Conclusion Modifiable factors which facilitate hospital-based OUD treatment initiation and continuation include availability of in-hospital addiction expertise to offer easily accessible, patient-centered treatment and the use of methadone or buprenorphine to manage opioid withdrawal. Further research and public policy efforts are urgently needed to address reported barriers to hospital-based OUD treatment initiation and continuation which include unstable housing, poorly controlled chronic medical and mental illness, and lack of social support. Supplementary Information The online version contains supplementary material available at 10.1007/s11606-021-07305-3.

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Hospital policy as a harm reduction intervention for people who use drugs

Lennox¹,

Martin²,

Brimner³

et al. 2021

International Journal of Drug Policy

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The Cost of a Cigarette: Opportunities to Engage Hospitalized Patients With Opioid Use Disorder

Abstract: Ensuring the safety of hospitalized patients with opioid use disorder who inject substances frequently presents management challenges for hospital staff. This commentary expounds on those challenges and offers areas of opportunity to provide patient-centered care for these patients.

Cited by 3 publications

References 3 publications

In-hospital Substance Use Policies: An Opportunity to Advance Equity, Reduce Stigma, and Offer Evidence-based Addiction Care

In-hospital Substance Use Policies: An Opportunity to Advance Equity, Reduce Stigma, and Offer Evidence-based Addiction Care

Opioid Use Disorder Treatment Initiation and Continuation: a Qualitative Study of Patients Who Received Addiction Consultation and Hospital-Based Providers

Hospital policy as a harm reduction intervention for people who use drugs

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