addiction

Treat opioid addiction in hospital ED for better results

There may be lasting benefits to giving people addicted to opioids medication to reduce cravings while in the hospital emergency department (ED).

The benefits of such treatment persist for two months after the initial visit to the ED, according to a new study published in the Journal of General Internal Medicine.

A prior study showed that people with opioid addiction who were treated with medication in the ED were more likely to get treatment beyond the ED and lessen their opioid use. But it was not clear how long the benefits of medication initiated in the ED would last.

In the long-term follow-up from the randomized trial, researchers provided one of three interventions to 290 individuals with opioid addiction who visited the ED. Patients received a referral to addiction treatment services, a brief interview including discussion of treatment, or a brief interview together with the medication buprenorphine. The third group continued medication in primary care.

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The research team evaluated patients at two, six, and 12 months following the ED interventions. For each individual, they assessed participation in addiction treatment, opioid use, and HIV risk, in addition to taking urine tests.

At the end of two months, patients who received buprenorphine from the ED were more likely to be in formal addiction treatment, and also to report reduced opioid use, compared to the other groups. There were no significant differences in HIV risk or the urine test results.

“The ED visit is an ideal opportunity to identify patients with opioid use disorder and initiate treatment and direct referral, similar to best practices for other diseases, such as high blood pressure and diabetes,” says Gail D’Onofrio. professor of emergency medicine at Yale University.

The findings add to mounting evidence that medication treatment for opioid users, initiated in the ED and continued in primary care, improves outcomes for patients as long as the intervention is continued. The researchers are currently leading an NIH-funded study disseminating this model in emergency departments in four cities around the country.

David Fiellin, professor of medicine, is a coauthor of the work funded by the National Institute on Drug Abuse.

Source: Yale University

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