Background: Hospitalizations related to opioid use disorder (OUD) are rising, creating opportunities to initiate medications for opioid use disorder (MOUD) and connect patients with outpatient resources.1,2 Despite evidence that MOUD reduces morbidity and mortality, most patients fail to receive evidence-based treatment during hospitalization.3-6 Addiction consultation services are becoming the standard of care to address this [...]

Background: Hospitalizations related to opioid use disorder (OUD) are rising, creating opportunities to initiate medications for opioid use disorder (MOUD) and connect patients with outpatient resources.1,2 Despite evidence that MOUD reduces morbidity and mortality, most patients fail to receive evidence-based treatment during hospitalization.3-6 Addiction consultation services are becoming the standard of care to address this [...]

Background: Patients with substance use disorders (SUD) are frequently cared for by hospitalists and admission presents an opportunity to engage patients in SUD treatment. Currently, patients with SUD are undertreated with medications to treat SUD, despite proven reduction in mortality. Addiction consult services are increasingly seen as an intervention to improve the quality of care [...]

Background: Medication for opioid use disorder (MOUD) reduces mortality1-5 and is considered standard of care in all health care settings6, yet overall use of these life-saving medications remains low.7 Hospitalization represents a crucial opportunity to offer treatment and link patients to outpatient care. Patients who start MOUD during hospitalization are more likely to continue treatment [...]

Background: Patients with opioid use disorder (OUD) are frequently hospitalized, however up to 25% of these encounters end in patient directed discharge (PDD), leading to interruptions in care, increased mortality, and higher hospital readmission rates.1-4 Receipt of medications for opioid use disorder (MOUD) has been shown to decrease odds of PDD.5 However, to date, less [...]

Background: Opioid overdose is a well-established cause of morbidity and mortality in the United States1. Naloxone is an opioid antagonist and harm-reducing treatment with a complex history of prescribing behaviors, attitudes, availability and reimbursement2. Interventions to increase appropriate co-prescription of naloxone include government mandates3 and Electronic Health Record (EHR) clinical decision support4. Our institution used [...]

Background: The opioid crisis remains a threat to public health nationwide. In NYC, there were 3,046 drug overdose deaths in 2023, a decrease of only 1% from 2022, with fentanyl involved in 80% of these fatalities. In 2021, the emergency department at our institution began distributing take-home naloxone kits to at-risk individuals on discharge through [...]

Case Presentation: A 31-year-old male with a past medical history of opiate use disorder and presumed Granulomatosis with polyangiitis (GPA) on chronic prednisone was admitted for lower extremity edema, sore throat, hemoptysis, and dyspnea. He also reported a progressively worsening mouth ulcer for the past 6 months. He was found to have bilateral lower extremity [...]

Case Presentation: A 61-year-old man with a history of opioid use disorder, methamphetamine use disorder, and chronic bilateral lower extremity wounds presented with worsening lower extremity pain and drainage (Figures 1 and 2). He was admitted for intravenous antibiotic treatment for lower extremity cellulitis. He reported inhaling fentanyl and methamphetamine on the day of presentation, [...]

Case Presentation: A 44-year-old female with severe opioid use disorder (OUD) was admitted after a benzodiazepine withdrawal seizure. Her history was significant for methadone 165 mg daily dosing, anxiety managed with daily unprescribed benzodiazepines, and alcohol use disorder in remission. She had a prolonged QT interval, with a notable episode 18 months prior, when she [...]