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Published on: November 11, 2013
A transitional opioid program to engage hospitalized drug users.
Christopher W Shanahan1, Donna Beers, Daniel P Alford
1Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA. cshanaha@bu.edu
Journal of General Internal Medicine
|March 19, 2010
Summary
Hospitalization offers a key opportunity to connect opioid-dependent patients to addiction treatment. The Transitional Opioid Program (TOP) successfully linked a majority of eligible hospitalized patients to ongoing care.
Area of Science:
- Addiction Medicine
- Public Health
- Hospital-based Interventions
Background:
- Opioid-dependent patients often miss addiction care during medical hospitalizations.
- The Transitional Opioid Program (TOP) leverages hospital stays as a critical opportunity for intervention.
Purpose of the Study:
- To evaluate the experience and outcomes of the Transitional Opioid Program (TOP).
- To assess the feasibility of using hospitalization as a "reachable moment" to initiate addiction treatment for opioid-dependent individuals.
Main Methods:
- A program nurse identified and enrolled hospitalized opioid-dependent patients not currently in treatment.
- Patients received interim opioid agonist treatment (stabilization and taper) post-discharge.
- Case management included HIV risk reduction, health education, counseling, and medical follow-up.
Main Results:
- From 2002-2005, 203 opioid-dependent patients were enrolled in TOP.
- 82% attended post-discharge clinic; 59% received treatment.
- Adherence to medical recommendations was observed among program participants.
Conclusions:
- The TOP successfully identified and engaged a majority of eligible hospitalized patients into addiction treatment.
- Hospitalization serves as a valuable "reachable moment" to connect individuals with substance use disorders to care.
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