Treating Opioid Use Disorder in Patients Who Are Incarcerated

South, Anna-Maria; Fanucchi, Laura; Lofwall, Michelle R.

doi:10.1001/jama.2023.5904

Cited by 8 publications

(5 citation statements)

References 3 publications

(7 reference statements)

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“…The study outcomes are defined a priori as visit to ED within 30-days of an index event [ 8 ]. 30-day ED revisits are defined as all cause visit to ED within 30-days of the index visit.…”

Section: Methodsmentioning

confidence: 99%

“…Policymakers and hospitals in Ontario are designing new interventions to reduce high rates ED and hospitalizations among SUD populations because patients with SUD may benefit from targeted hospital-based substance use support [ 5 – 8 ]. Since revisits to ED are a proxy to measure effective treatment for SUD, and a direct indicator for increased health system use [ 9 ], interventions that may modify the occurrence of revisit events could improve patient care and reduce health resource costs.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Association of hospital-based substance use supports on emergency department revisits: a retrospective cohort study in Sudbury, Canada from 2018 to 2022

Tatangelo,

Landry,

Beaulieu

et al. 2024

Harm Reduct J

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Background This study compares emergency department (ED) revisits for patients receiving hospital-based substance-use support compared to those who did not receive specialized addiction services at Health Sciences North in Sudbury, Ontario, Canada. Methods The study is a retrospective observational study using administrative data from all patients presenting with substance use disorder (SUD) at Health Sciences North from January 1, 2018, and August 31, 2022 with ICD-10 codes from the Discharge Abstract Database (DAD) and the National Ambulatory Care Database (NACRS). There were two interventions under study: addiction medicine consult services (AMCS group), and specialized addiction medicine unit (AMU group). The AMCS is a consult service offered for patients in the ED and those who are admitted to the hospital. The AMU is a specialized inpatient medical unit designed to offer addiction support to stabilize patients that operates under a harm-reduction philosophy. The primary outcome was all cause ED revisit within 30 days of the index ED or hospital visit. The secondary outcome was all observed ED revisits in the study period. Kaplan–Meier curves were used to measure the proportion of 30-day revisits by exposure group. Odds ratios and Hazard Ratios were calculated using logistic regression models with random effects and Cox-proportional hazard model respectively. Results A total of 5,367 patients with 10,871 ED index visits, and 2,127 revisits between 2018 and 2022 are included in the study. 45% (2,340/5,367) of patient were not admitted to hospital. 30-day revisits were less likely among the intervention group: Addiction Medicine Consult Services (AMCS) in the ED significantly reduced the odds of revisits (OR 0.53, 95% CI 0.39–0.71, p < 0.01) and first revisits (OR 0.42, 95% CI 0.33–0.53, p < 0.01). The AMU group was associated with lower revisits odds (OR 0.80, 95% CI 0.66–0.98, p = 0.03). For every additional year of age, the odds of revisits slightly decreased (OR 0.99, 95% CI 0.98–1.00, p = 0.01) and males were found to have an increased risk compared to females (OR 1.50, 95% CI 1.35–1.67, p < 0.01). Interpretation We observe statistically significant differences in ED revisits for patients receiving hospital-based substance-use support at Health Sciences North. Hospital-based substance-use supports could be applied to other hospitals to reduce 30-day revisits.

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“…The study outcomes are defined a priori as visit to ED within 30-days of an index event [ 8 ]. 30-day ED revisits are defined as all cause visit to ED within 30-days of the index visit.…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association of hospital-based substance use supports on emergency department revisits: a retrospective cohort study in Sudbury, Canada from 2018 to 2022

Tatangelo,

Landry,

Beaulieu

et al. 2024

Harm Reduct J

View full text Add to dashboard Cite

show abstract

“…In Reply We thank Dr Wei and Dr Woodruff and colleagues for their thoughtful Letters in response to our Viewpoint highlighting the ethical, legal, and policy issues raised by caring for a real patient with OUD who was prevented from receiving medication for OUD while incarcerated. Wei reminds us that it is illegal to provide medication for OUD in prisons in Taiwan; advocacy for treatment in Taiwanese jails has failed due to skeptics in the judicial system, a powerful policy driver in many countries.…”

mentioning

confidence: 99%

Opioid Use Disorder Treatment for Patients Who Are Incarcerated—Reply

South,

Lofwall,

Fanucchi

2023

JAMA

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“…To the Editor As a Taiwanese physician specializing in addiction medicine, I read with great interest the recent Viewpoint that discussed the complex ethical and legal issues surrounding treating opioid use disorder (OUD) for incarcerated patients in the US. While the situation in the US is concerning, OUD treatment options in prisons in Taiwan are even more limited.…”

mentioning

confidence: 99%