Opportunities to improve inpatient services and reduce rates of patient-direct discharge among people who use substances.

Purpose: Patients who use substances (PWUS) report experiencing stigmatizing encounters and undertreatment of pain and withdrawal symptoms that increase the likelihood of patient-directed discharge (PDD). This scoping review examines North American literature to gain insights about how institutional factors intersect with patient experiences and contribute to PDD.

Methods: A scoping review was conducted using MEDLINE, CINAHL, Scopus, and EMBASE databases.