Researchers in Canada have found a significant number of individuals with co-occurring mental health and substance use disorders are admitted to inpatient psychiatric units. We looked at those admitted to an acute care hospital in Vancouver, British Columbia, whom had been referred to an addiction medicine consult team, to develop a greater understanding of this population and of the care being provided in order to improve care outcomes and patients’ care experiences.
Hospital based opioid agonist treatment
We collected data from the medical records of 45 randomly selected psychiatric inpatients referred to the AMCT between April 30, 2016 and May 1, 2017. We assessed the characteristics of those referred, the reasons for referrals, and the care provided. The data was analyzed using descriptive statistics.
The sample was mostly males (64.4%), individuals with a number of medical comorbidities, and admitted involuntarily. The majority of patients (90%) had more than one substance use disorder. The main reason for referral was related to opioid use (60%), and the team social worker was involved in the care of 26 (57.85%) of those referred. On discharge, only 10 (22.2%) individuals were provided with a Take Home Naloxone kit and only seven (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 Canadian hospital. Strategies to improve the implementation of overdose prevention, and opioid agonist treatment, in hospitals 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.