Study Shows Potential for Hospital-Based Strategies to Address Opioid Epidemic

The combination of expanding hospital-based prescribing of medications for opioid use disorder (OUD) and implementing addiction consult services could be the basis for a hospital-based strategy for improving life expectancy and reducing healthcare costs, according to a new study funded by the National Institute on Addictive Disorders (NIDA) and the National Institute of Allergy and Infectious Diseases.

“Hospitals have become an important touchpoint for opioid use disorder care, where complications such as overdose and serious injection-related infections can be prevented; thus, hospital administrators and providers must consider strategies to optimally treat this population,” the researchers who conducted the study wrote in their findings, published by The Lancet.

“Just as it is unacceptable for major hospitals to be without specialist services such as cardiologists, obstetricians, or infectious disease specialists, it should be considered unacceptable to be without addiction treatment services amid an ever-expanding overdose crisis in countries like the USA. 

Researchers developed a microsimulation model to compare the cost of standard hospital care (defined as detoxification for opioids and no addiction consult service), expanded inpatient prescribing of medications for OUD including “bridge medications” (medications provided until the patient can see an outpatient provider), implementation of addiction consult services within the hospital, and the combination of medication for OUD and addiction consult services strategy.

The study found that among those who inject opioids, expanding medications for OUD with bridge prescriptions would reduce hospitalizations and overdose deaths by an estimated 3.2% and 3.6%, respectively. The combination of expanded medications and addiction consult services would reduce hospitalizations and overdoses by 5.2% and 6.6%, respectively.

“Although investing resources to improve opioid use disorder care in hospitals would be of high value, implementing an addiction consult strategy alone as the sole purveyor of medications for opioid use disorder, without a larger supporting workforce of prescribers, might not be a particularly high value endeavor due to the capacity limitations faced by addiction consult services,” the researchers wrote.