Role of the Hospital in the 21st Century Opioid Overdose Epidemic: The Addiction Medicine Consult Service

Kelsey C. Priest, Dennis Mccarty

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Objective:The aim of the study was to explore and describe the structure and design elements of addiction medicine consult (AMC) services within selected US hospitals.Methods:As part of a larger mixed methods study, 10 qualitative semi-structured telephone interviews were completed with board-certified addiction medicine physicians affiliated with the Addiction Medicine Foundation's Addiction Medicine Fellowship Programs at 9 US hospitals. Interviews were transcribed, coded, and analyzed using a directed content analysis.Results:Interviews completed with established AMC services in 9 hospitals probed AMC structure and design commonalities and differences across 4 domains: (1) availability and coverage, (2) team composition, (3) scope and responsibility, and (4) financing. Only 1 service provided weekend consults and most services did not provide coverage in the emergency department. Interprofessional teams were common with a variety of discipline combinations. AMC service scope and responsibility, generally, included 3 types of activities: (1) education and culture change, (2) the delivery of psychosocial and medical services, and (3) hospital guidance document development. Finally, most AMC services existed within a fragile financial environment with idiosyncratic arrangements.Conclusions:As opioid use disorder (OUD)-related hospitalizations increase stakeholders look to innovative care delivery mechanisms to improve care and outcomes for persons with OUD. The implementation of an AMC service may be an organizational intervention for achieving these aims. Understanding the shared and different approaches to AMC service structure and design is an important first step for delivery systems interested in implementing or expanding these services.

Original languageEnglish (US)
Pages (from-to)104-112
Number of pages9
JournalJournal of addiction medicine
Volume13
Issue number2
DOIs
StatePublished - Mar 1 2019

Keywords

  • addiction consult service
  • addiction medicine
  • addiction medicine consult service
  • buprenorphine
  • buprenorphine/naloxone
  • health service delivery
  • hospital
  • medication-assisted therapy
  • methadone
  • opioid agonist therapy
  • opioid overdose
  • opioid use disorder

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)

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