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Effectiveness of Substance Use Navigation for Emergency Department Patients With Substance Use Disorders: An
Erik S Anderson1, Evan Rusoja2, Joshua Luftig3
1Department of Emergency Medicine, Highland Hospital - Alameda Health System, Oakland, CA; Substance Use Disorder Program, Highland Hospital - Alameda Health System, Oakland, CA.
Annals of Emergency Medicine
|November 19, 2022
Summary
A new intervention by substance use navigators (SUN) significantly increased addiction treatment engagement for emergency department patients. This whole person care approach improved outcomes for patients with alcohol, opioid, and cocaine use disorders.
Area of Science:
- Public Health
- Addiction Medicine
- Implementation Science
Background:
- Emergency departments (EDs) frequently encounter patients with substance use disorders (SUDs).
- Effective interventions are needed to connect these patients with ongoing addiction treatment post-discharge.
Purpose of the Study:
- To evaluate a whole person care-informed intervention delivered by substance use navigators (SUNs) for ED patients with SUDs.
- To determine the impact of the SUN intervention on treatment engagement within 30 days of ED discharge.
Main Methods:
- Implementation study involving adult patients discharged from 3 public hospital EDs.
- Comparison of treatment engagement rates between patients who received the SUN intervention and those who did not.
- Logistic regression and propensity score matching were used to control for confounding factors.
Main Results:
- The SUN intervention was associated with a significantly higher rate of outpatient treatment engagement (34.5% difference).
- Multivariable and propensity score-matched analyses showed the SUN intervention increased the odds of treatment engagement (aOR 3.7, OR 2.1).
- Patients with methamphetamine use disorders showed low engagement regardless of the intervention.
Conclusions:
- A whole person care-informed intervention delivered by SUNs is strongly associated with improved addiction treatment engagement for ED patients with SUDs.
- The SUN intervention shows promise for enhancing continuity of care for individuals with alcohol, opioid, and cocaine use disorders.
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