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UPMC: Addiction medicine consultations can save lives

A new study published in the Journal of General Internal Medicine by University of Pittsburgh physicians found that in-hospital addiction medicine consultations can help reduce deaths in high-risk patients with substance use disorder.

The study included more than 700 high-risk patients who were admitted to UPMC Presbyterian hospital and were diagnosed with either alcohol or opioid use disorder.

The patients received an addiction medicine consultation that connected them to outpatient treatments, including medications, but also provided an opportunity to speak about their substance use with trained members of the addiction medicine team.

Researchers found that among patients with opioid and alcohol use disorder, working with the addiction medicine consult team led to a significantly reduced risk of death within three months of discharge from the hospital.

“The addiction medicine consult team is a team that consists of a physician who is trained in addiction medicine, a nurse that has addiction training, a person with lived experience who is in recovery themselves, and a social worker,” explained Dr. Deanna Wilson, assistant professor of medicine and pediatrics at the University of Pittsburgh School of Medicine and lead author of the paper.

“The consult team (meets) patients in the hospital who have substance use disorder, and they do an evaluation, they talk to patients in a compassionate, nonjudgmental way, and offer to start treatment in the hospital, and help patients link to treatment once they leave the hospital,” she said.

The program isn’t in Butler County yet, but Wilson said UPMC was interested in looking into how programs could be incorporated in other hospitals.

“There’s a lot of interest across the UPMC health care system in looking at models like this and figuring out how they could potentially implement them,” she said. “I don’t know the logistics about which hospitals and when, but I know there is a lot of interest in thinking about how to adapt this kind of team to other hospitals in our area, particularly because this area has been so hard hit by the overdose crisis.”

Providing aid in a crisis

Wilson, who also works on the team as one of several rotating providers, was encouraged by the progress of the study and the opportunity to offer care to those in crisis.

“There are very few things that we do in medicine that can actually reduce mortality and the likelihood that someone will die once they leave the hospital, so I think that is the significant finding,” she said. “This shows that something that you can do in the hospital can impact patients for 90 days after they leave it.”

Wilson added that the study emphasizes the need for health systems to invest in comprehensive services for substance use disorder.

“This shows that if they are able to do that, we can actually save lives,” she said. “The patients are meeting a team of people who do not judge them, who are able to talk to them in ways that don’t make them feel bad about themselves and bad about their addiction, and are really able to connect with them.”

The peer members of the team who have their own lived experiences with addiction and recovery, she said, can draw on their own recovery to connect with patients.

“They can show them that there’s hope, that they can get access to treatment and get well,” she said. “That’s a large part of what the consult service does is offer emotional support in addition to medications. The idea is that all of the interventions that the team does to support patients and help motivate them lead to improved health outcomes across the board.”