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: Despite a public health crisis – over 500,000 individuals have died from opioid overdoses since 2000 – and the availability of effective therapies, most patients with Opioid Use Disorder (OUD) are not offered treatment. Medication-Assisted Treatment (MAT), such as with buprenorphine, is associated with significantly higher rates of abstinence and follow-up, lower rates of [...]

Background: Despite medical advancements for organic and structural diseases, effectively managing acute and chronic functional pain syndromes remains a daunting challenge for hospitalists. Standard inpatient treatments frequently fail to adequately control symptoms, often compelling hospitalists to shift from diagnostics to the contentious task of tapering opioids in patients with legitimate pain. This pivot can lead [...]

Background: Despite evidence that the use of medications for patients with opioid use disorder (OUD) leads to reduced mortality and improved engagement in outpatient addiction treatment, these life-saving medications are underutilized in the hospital setting. This study reports the outcomes of a hospitalist-led interprofessional and multidisciplinary inpatient program, known as the B-Team (buprenorphine team), to [...]

Background: There were approximately 46,000 opioid overdose deaths in 2017. It is known that opioid overdose risk is increased in patients with a diagnosis of substance use disorder, prior opioid overdose, and high suspicion of risk as assessed by clinical teams. The Risk Index for Overdose or Serious Opioid-Induced Respiratory Depression (RIOSORD) is a validated [...]

Background: Prior studies have found racial disparities in how patients are assessed for pain and prescribed opioids from emergency department and surgical settings. However, we do not know whether similar disparities exist among general medicine inpatients. We examined opioid prescriptions at discharge among adults admitted to the general medicine service at our medical center, with [...]

Background: Despite a public health crisis – over 500,000 individuals have died from opioid overdoses since 2000 – and the availability of effective therapies, most patients with Opioid Use Disorder (OUD) are not offered treatment. Medication-Assisted Treatment (MAT), such as with buprenorphine, is associated with significantly higher rates of abstinence and follow-up, lower rates of [...]

Background: Despite medical advancements for organic and structural diseases, effectively managing acute and chronic functional pain syndromes remains a daunting challenge for hospitalists. Standard inpatient treatments frequently fail to adequately control symptoms, often compelling hospitalists to shift from diagnostics to the contentious task of tapering opioids in patients with legitimate pain. This pivot can lead [...]

Background: The American opioid epidemic is a public health emergency, with over 100,000 opioid-related overdose deaths occurring in 2021 (1). Harm reduction treatment models, formulated with the goal of reducing the negative consequences of opioid use, have been implemented as an alternative approach in minimizing opioid overdose and mortality (2). With approximately 4-11% of hospitalized [...]

Background: Methylnaltrexone (MNTX) is a peripherally acting µ-opioid receptor antagonist indicated for opioid-induced constipation (OIC), which can be a serious consequence of opioid analgesia. We evaluated whether baseline osmotic agent (eg, milk of magnesia, polyethylene glycol, lactulose, sorbitol) or stimulant (eg, senna, bisacodyl) use affects the efficacy and safety of MNTX among a subgroup of [...]