A Transitional Opioid Program to Engage Hospitalized Drug Users

Abstract

The Transitional Opioid Program (TOP) identified at-risk hospitalized, out-of-treatment opioid-dependent drug users and, by offering a range of treatment intensity options, engaged a majority into addiction treatment. Hospitalization can be a "reachable moment" to engage and link drug users into addiction treatment.

“It’s been an Experience, a Life Learning Experience”: A Qualitative Study of Hospitalized Patients with Substance Use Disorders

“…First, participants identified the presence of caring staff as a key contributor to their staying in the hospital instead of leaving against medical advice, and in engaging in treatment. Our findings echo those in studies of patients with SUD in primary care, which revealed higher satisfaction among patients who perceived that providers trusted, respected, and empathized with them, 12,13 as well as higher satisfaction for patients who perceived physician concerns about Byou as a patient^and Bbeing treated like a patient instead of a drug addict.^1 4 Feeling cared for in a relationship was particularly important to vulnerable hospitalized patients. Participants also noted the importance of staff who knew how to treat withdrawal, 15 and felt that variation in treatment implied that some providers were delivering substandard care.…”

“…8 Our findings suggest that when MAT is offered in the hospital, it is important to provide an array of treatment options, and that MAT Bmay not be for everybody.^These findings support literature reports of patients wanting an individualized approach to treatment. 18 However, while earlier studies have supported the feasibility of initiating MAT in the hospital, 4,7,8 our study highlights key barriers that could limit the generalizability of these interventions. Specifically, the gap between discharge and entry into treatment can be substantial, and systems need rapid-access pathways from inpatient hospitalization to community SUD treatment.…”

“…[1][2][3][4][5] Despite frequent contact with healthcare systems, many people are not engaged in addiction treatment. 3,6 Hospitalization is often unplanned, and most persons do not come to the hospital seeking addiction treatment.…”

“…A handful of interventions have shown that it is feasible to initiate medication-assisted treatment (MAT) for SUD in the hospital, 4,7,8 and that doing so can increase the likelihood of patients engaging in SUD treatment after discharge. However, these interventions have shown high rates of attrition in treatment.…”

Reduction in healthcare utilization and costs following residential integrated treatment for co-occurring substance use and mental health disorders

“…[7] Opiate users often receive care in ERs, one of the most expensive points of entry to the healthcare system. [8] Oxycodone-based medications were the pain relievers most commonly involved in ER visits (56.2 visits per 100,000). [9] Prescription drug users make up 55% of the estimated 8.9 million drug users in the United States and hospitalizations for opiates are highest for prescription drugs.…”