Leadership Roles in Opioid Stewardship and the Treatment of Patients with Opioid Use Disorder Among Medical Toxicologists

Carpenter, Joseph; Murray, Brian Patrick; Mazer‐Amirshahi, Maryann; Laes, Jo An R.; Nacca, Nicholas; Nelson, Lewis S.; Perrone, Jeanmarie; Schwarz, Evan S.; Wiegand, Timothy J.; Wax, Paul M.

doi:10.1007/s13181-019-00752-9

Cited by 2 publications

(1 citation statement)

References 23 publications

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“…[28] A survey of members of the American College of Medical Toxicology, whose membership represents more than 80% of the board certified medical toxicologists in the USA, found that 60% had a DATA 2000 X-waiver to prescribe buprenorphine, 21% were board certified in Addiction Medicine, and 17% held institutional leadership roles to address clinical treatment for opioid use disorder. [21,29] Medical toxicologists not only provide expert consultation regarding treatment of intoxication and withdrawal syndromes, but also provide expertise around MAT induction and maintenance. [30] By implementing a MAT linkage program, we demonstrated the previously described extension of the typical medical toxicology practice to include these services.…”

Section: Discussionmentioning

confidence: 99%

Implementation of a Medication for Addiction Treatment (MAT) and Linkage Program by Leveraging Community Partnerships and Medical Toxicology Expertise

et al. 2020

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Introduction Implementing a hospital medication for addiction treatment (MAT) and a linkage program can improve care for patients with substance use disorder (SUD); however, lack of hospital funding and brick and mortar SUD resources are potential barriers to feasibility. Methods This study assesses the feasibility of implementation of a SUD linkage program. Components of the program include a county-funded hospital opioid support team (HOST), a hospital-employed addiction recovery specialist (ARS), and a medical toxicology MAT induction service and maintenance program. Data for linkage by HOST, ARS, and MAT program were tracked from July 2018 to December 2019. Results From July 2018 through December 2019, 1834 patients were linked to treatment: 1536 by HOST and 298 by the ARS.The most common disposition categories for patients linked by HOST were 16.73% to medically monitored detoxification, 9.38% to intensive outpatient, and 8.59% to short-term residential treatment. Among patients linked by the ARS, 65.66% were linked to outpatient treatment and 9.43% were linked directly to inpatient treatment. A total of 223 patients managed by the ARS were started on MAT by medical toxicology and linked to outpatient MAT clinic: 72.68% on buprenorphine/naloxone, 24.59% on naltrexone, 1.09% buprenorphine, and 0.55% acamprosate. Conclusion Implementing a MAT and linkage program in the ED and hospital setting was feasible. Leveraging medical toxicology expertise as well as community and funding partnerships was crucial to successful implementation.

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Section: Discussionmentioning

confidence: 99%