Treatment for opioid use disorder is rare in hospitals, study finds

May 07, 2020

Despite a national opioid-related overdose epidemic that continues to claim tens of thousands of lives annually, a new nationwide study shows that a scant proportion of hospitalized patients with opioid use disorder receive proven life-saving medications both during and after they're discharged.

The study published in the Journal of General Internal Medicine.

"It really paints a bleak picture of the current state of affairs about the treatment of people with opioid use disorder nationwide," said lead author Kelsey Priest, Ph.D., M.P.H., a health systems researcher and current M.D./Ph.D. student in the Oregon Health & Science University School of Medicine.

The study plumbed an extensive database of patients in the Department of Veterans Affairs health care system. Researchers identified more than 12,000 patients across 109 hospitals who were hospitalized for various reasons but also had underlying opioid use disorder during the fiscal year ending in 2017.

The researchers identified 10,969 patients who had opioid use disorder at the time they were hospitalized but weren't receiving treatment. Of those patients, only 203 - 2% - received a medication to treat opioid use disorder while they were in the hospital and were subsequently linked to care after their discharge. That's important because findings from an earlier study from OHSU showed that patients who received medication such as buprenorphine in the hospital are twice as likely to continue their therapy after discharge.

"This is a huge missed opportunity," said co-author Honora Englander, M.D., associate professor of medicine in the OHSU School of Medicine.

Englander is director of an in-hospital intervention program that OHSU started in 2015.

Project IMPACT, or Improving Addiction Care Team, brings together physicians, social workers, peer-recovery mentors and community addiction providers to address addiction when patients are admitted to the hospital. The program is a rare exception, although part of a small but growing cohort of hospitals nationwide implementing these services. The need for these interventions is clear based on the study published today.

"Hospitalization is a reachable moment to initiate and coordinate therapy to treat substance use disorder," Englander said. "This study shows that in the VA - which most likely out-performs other U.S. hospitals - life-saving, evidence-based treatment is rarely prescribed."

Opioid agonist therapies available in the hospital include methadone or buprenorphine. Both relieve withdrawal symptoms and pain, normalizing brain function by acting on the same targets in the brain as prescription opioids or heroin.
-end-
The study was supported by the National Institute on Drug Abuse of the National Institutes of Health, grants F30 DA044700, R33 DA035640, and UG1 DA015815; the Greenlick Family Scholarship Fund and the U.S. Department of Veterans Affairs Health Services Research & Development, grant IK2HX001516. The contents are those of the authors and do not represent the views of the U.S. Department of Veterans Affairs or the U.S. government.

Oregon Health & Science University

Related Brain Articles from Brightsurf:

Glioblastoma nanomedicine crosses into brain in mice, eradicates recurring brain cancer
A new synthetic protein nanoparticle capable of slipping past the nearly impermeable blood-brain barrier in mice could deliver cancer-killing drugs directly to malignant brain tumors, new research from the University of Michigan shows.

Children with asymptomatic brain bleeds as newborns show normal brain development at age 2
A study by UNC researchers finds that neurodevelopmental scores and gray matter volumes at age two years did not differ between children who had MRI-confirmed asymptomatic subdural hemorrhages when they were neonates, compared to children with no history of subdural hemorrhage.

New model of human brain 'conversations' could inform research on brain disease, cognition
A team of Indiana University neuroscientists has built a new model of human brain networks that sheds light on how the brain functions.

Human brain size gene triggers bigger brain in monkeys
Dresden and Japanese researchers show that a human-specific gene causes a larger neocortex in the common marmoset, a non-human primate.

Unique insight into development of the human brain: Model of the early embryonic brain
Stem cell researchers from the University of Copenhagen have designed a model of an early embryonic brain.

An optical brain-to-brain interface supports information exchange for locomotion control
Chinese researchers established an optical BtBI that supports rapid information transmission for precise locomotion control, thus providing a proof-of-principle demonstration of fast BtBI for real-time behavioral control.

Transplanting human nerve cells into a mouse brain reveals how they wire into brain circuits
A team of researchers led by Pierre Vanderhaeghen and Vincent Bonin (VIB-KU Leuven, Université libre de Bruxelles and NERF) showed how human nerve cells can develop at their own pace, and form highly precise connections with the surrounding mouse brain cells.

Brain scans reveal how the human brain compensates when one hemisphere is removed
Researchers studying six adults who had one of their brain hemispheres removed during childhood to reduce epileptic seizures found that the remaining half of the brain formed unusually strong connections between different functional brain networks, which potentially help the body to function as if the brain were intact.

Alcohol byproduct contributes to brain chemistry changes in specific brain regions
Study of mouse models provides clear implications for new targets to treat alcohol use disorder and fetal alcohol syndrome.

Scientists predict the areas of the brain to stimulate transitions between different brain states
Using a computer model of the brain, Gustavo Deco, director of the Center for Brain and Cognition, and Josephine Cruzat, a member of his team, together with a group of international collaborators, have developed an innovative method published in Proceedings of the National Academy of Sciences on Sept.

Read More: Brain News and Brain Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.