Background: America is facing an opioid epidemic. From 1997 to 2017 there were 702,000 deaths from drug overdoses of which greater than 50% were from opioids. The opioid epidemic knows no boundaries, it affects men and women of all age groups and socioeconomic status. Hospitalists are now seeing more opioid related hospital admissions which have grown by 64% between 2005 and 2014. Opioid detoxification is normally the strategy employed by treating physicians. This often leads to a decrease in physiologic tolerance and an increased risk of overdose upon discharge.Opioid agonist treatment for opioid use disorder has been shown to be safe, effective and potentially lifesaving. Despite the potential benefits it is widely underused. Even with the increase in opioid use disorder among hospitalized patients physicians continue to underrecognize and treat.
Purpose: We wanted to create a multidisciplinary approach to patients suffering from opioid use disorder. Ensuring patients were being screened and offered opioid agonist treatment.
Description: In order to improve our inpatient recognition and treatment of opioid use disorder. We implemented an education series for the Hospitalist division and nursing. This established a baseline knowledge for all providing care to these patients. Patients are identified as having Opioid use disorder either by bedside nursing or admitting hospitalist. Once done, a Screening, Brief Intervention and Referral to Treatment (SBIRT) is completed by our social workers. During this integrated public health approach interest in beginning opioid agonist treatment is assessed. If the patient is interested in learning more or starting treatment the social worker sends a message to a group of physicians who are able to prescribe agonist therapy. The physician who is on for the day does a bedside consult and discusses the benefits of opioid agonist therapy. Therapy is started if patient is accepting
Conclusions: From Aug 2022-Nov 2022 we had 19 patients interested in learning more about opioid agonist therapy 94% of the patients began inpatient Buprenorphine therapy. All patients were given community follow up for further treatment with Buprenorphine. Hospitalizations are a critical point in patients addiction recovery. It is a period of mental clarity and provides an opportunity to recognize the deleterious health effects. There are several benefits to recognizing and treating inpatient opioid withdrawal. It improves trust between patient and provider. Alleviating withdrawal symptoms decreases the chances a patient will leave against medical advice. These benefits increase the chances the acute medical condition can be treated in its entirety. Given the increase in admissions related to the sequala of opioid use disorder it is imperative hospitalists become leaders in this space. Our interdisciplinary approach to this complex disease process has helped us provide better care to this vulnerable population.