Work

Treatment of Opioid Use Disorder in the General Hospital

Year: 2023

Type: article

Abstract: In 2022, the APA Joint Reference Committee voted to approve a comprehensive Resource Document jointly sponsored by the APA Councils on Consultation-Liaison Psychiatry and Addiction Psychiatry for psychiatrists involved in the treatment of patients with Opioid Use Disorder (OUD) in the general hospital.The full Resource Document, which includes a comprehensive review of the literature, is available in a data supplement that accompanies the online version of this APA Official Action in the August issue of the American Journal of Psychiatry (ajp.psychiatryonline.org).The findings, opinions, and conclusions of this Resource Document do not necessarily represent the views of the officers, trustees, or all members of the American Psychiatric Association and do not represent APA policy.The following summary highlights essential concepts.The morbidity, mortality and cost of Opioid Use Disorder (OUD) has increased to dramatic levels, necessitating a call-to-action for health care systems and providers to reassess the approach to treatment of OUD.The inpatient general hospital, where there is often more time and resources for patient engagement, is an important point of entry into the health care system for patients with medical and surgical complications of OUD. IN-HOSPITAL MOUD INITIATION AND CONTINUATIONMany physicians are hesitant to initiate or continue medication for OUD (MOUD) due to incomplete understanding of Federal prescribing regulations.Any provider approved to prescribe buprenorphine for OUD, either via a filed Notice of Intent (NOI) for exemption for training through SAMHSA or via a DATA2000 waiver, can initiate and maintain buprenorphine monotherapy or buprenorphine/naloxone for a hospitalized patient with OUD.Providers who are not authorized or waivered may continue previously initiated MOUD, including methadone, for patients in the hospital.

Source: American Journal of Psychiatry

DOI: 10.1176/appi.ajp.23180008