Background: Previous studies have documented discriminatory refusals from post-acute care facilities related to opioid use disorder or opioid agonist therapy, however the impact of inability to secure skilled nursing facility (SNF) placement for patients with any substance use disorder (SUD) has not been fully explored. The objective of this study is to measure the odds [...]

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: The opioid epidemic continues to exert a significant impact on our health care system. Patients with intravenous drug use (IVDU) often develop life threating infections leading to prolonged hospitalizations with poor outcomes. Traditionally, the focus of treatment during these hospitalizations is on the infectious complications with very little emphasis on the underlying substance use [...]

Background: Alcohol use disorder (AUD) is the most prevalent substance use disorder, but most patients with AUD do not receive evidence-based medications for AUD (MAUD), including naltrexone or acamprosate. Inpatient addiction consult services (ACS) may offer an opportunity to start medical treatment for hospitalized patients with AUD, but it is unknown if ACS are associated [...]

Background: The US faces a worsening epidemic of substance use-associated morbidity and mortality. In 2021, over 46 million people had a substance use disorder (SUD) and over 109,000 overdose deaths occurred. Furthermore, an estimated 1 in 7 hospital admissions are for patients with SUDs. Stigma is pervasive among these patients’ hospital providers, and SUD management [...]

Background: Substance use continues to increase in the United States. Substance use has been linked to new onset cardiovascular and cerebrovascular disorders which lead to hospitalizations. We aimed to assess the association of epidemiology and racial disparities of substance use disorders (SUDs) using the National Inpatient Sample (NIS) Database. Methods: A retrospective study of the [...]

Background: Hospitalists often care for patients who have substance use disorders as well as patients who are incarcerated. Availability of medications for substance use disorders (MSUD) varies based on state law and access varies based on facility, city, and county. Since hospitalization presents a unique opportunity to prevent negative consequences of substance use disorders, it [...]

Background: Prior studies have found Black and Hispanic patients are more likely to experience disparities in pain management. Fewer studies have evaluated pain control based on age, sex, body mass index (BMI), or presence of a substance use disorder (SUD). While factors influencing management of acute pain are complex, striving for adequate pain control remains [...]

Background: At its 2014 peak, the opioid overdose crisis claimed nearly 30,000 lives, but many hospitals and health systems have small opioid-related initiatives working in disjointed fashion rather than a cohesive response.  Purpose: We created a hospital-wide initiative called the “Brigham Comprehensive Opioid Response and Education” (B-CORE) program to reduce opioid-related morbidity and mortality in [...]

Background: Over the last few years, the USA has seen a sharp increase in the incidence and prevalence of substance use disorder (SUD) and related acute illnesses. The clinical course of many hospitalized patients is impacted by their diagnosis of SUD. At our institution, we put in place an inpatient addiction service where a physician [...]