In-hospital addiction medicine consultations can reduce deaths in high-risk patients with substance use disorder, according to a new study published in the Journal of General Internal Medicine by University of Pittsburgh physicians. This research is among the first of its kind to show these consults are a life-saving intervention.
In this past year, more people have died from overdose deaths than ever before. We know that patients who die from overdoses frequently come into contact with the health system. In the past, we often ignored substance use withdrawal or failed to link patients to any substance use treatment during hospitalization. We repeatedly lost the opportunity to intervene during a time when patients often were more amenable to help. Having a hospital-based addiction medicine consult team is a hospital-level intervention that allows us to save patients' lives."
Deanna Wilson, M.D., assistant professor of medicine and pediatrics, University of Pittsburgh School of Medicine and lead author of the paper
The study included more than 700 high-risk patients who were admitted to the hospital and were diagnosed with either alcohol or opioid use disorder. These patients received an addiction medicine consultation that connected them to outpatient treatments, including medications, but also provided an opportunity to speak about their substance use in a compassionate and non-stigmatizing way by trained members of the addiction medicine team.
Researchers found that among patients with opioid and alcohol use disorder, exposure to the addiction medicine consult team led to a significantly reduced risk of death within three months of discharge from the hospital. For patients with opioid use disorders, medication likely played a large role in reducing the risk of mortality. However, the impact of medication for patients with alcohol use disorder was less prevalent, suggesting other components of the consult team may play a key role.
As the COVID-19 pandemic continues to surge throughout the country, overdose deaths and substance use are expected to increase, making the need for large-scale interventions even more important.
"Thinking of outside-the-box solutions to support people with substance-use disorders will become ever more urgent as the pandemic drags on," Wilson continued. "We need to meet patients where they are and have conversations in a non-stigmatizing way. The addiction medicine consult team is a delivery model that can be adapted to each health system, can serve as a way to easily integrate and offer effective medication and behavioral therapies as they are developed, and has the potential to save lives."
Wilson, J.D., et al. (2022) Inpatient Addiction Medicine Consultation Service Impact on Post-discharge Patient Mortality: a Propensity-Matched Analysis. Journal of General Internal Medicine. doi.org/10.1007/s11606-021-07362-8.