Researchers recently found that many people with co-occurring mental health and substance use disorders are admitted to inpatient psychiatric units. According to a 2019 report from the Boston’s Institute for Healthcare Improvement and The Grayken Center, “hospitals have the opportunity to make a major impact in reducing morbidity and mortality related to opioid use.” The present study, therefore, looked at patients admitted to an acute care hospital in Vancouver, British Columbia. It sought to improve our understanding of this population and the care provided so that we can improve patients’ outcomes and care experiences.
Hospital based opioid agonist treatment
We collected data from the medical records of 45 randomly selected psychiatric inpatients between April 2016 and May 2017. All 45 patients have been referred to an addiction medicine consult team. We looked at their characteristics, the reasons for referrals, and the care provided. Descriptive statistics analyzed the data.
64% were men who had several medical comorbidities and were admitted involuntarily. Most patients (90%) had more than 1 substance use disorder. The main reason for referral was related to opioid use (60%). The team’s social worker was involved in the care of 26 (57.85%) of those referred. On discharge, only 10 (22.2%) patients got a Take Home Naloxone kit. Only 7 (43.8%) of those on opioid agonist therapy had documented follow-up for this treatment.
Polysubstance use and medical comorbidities appear common among psychiatric inpatients admitted to an inner-city acute care hospital. This offers a window of opportunity for engaging with patients to reduce drug related harms. Still, effective strategies for hospitals responding to the opioid crisis through improved overdose prevention and opioid agonist treatment are needed.
McWilliams, C., Bonnie, K., Robinson, S., Johnson, C., Puyat, J. H., Klimas, J. (2019) Preliminary Results of Psychiatric Inpatients Referred to an Addiction Medicine Consult Service. Journal of Addiction Medicine. doi: 10.1097/ADM.0000000000000580
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