A Novel Use of the "3-Day Rule": Post-discharge Methadone Dosing in the Emergency Department.

Introduction: Methadone is a medically necessary and lifesaving medication for many patients with opioid use disorder. To adequately address these patients' needs, methadone should be offered in the hospital, but barriers exist that limit its continuation upon discharge. The code of federal regulations allows for methadone dosing as an inpatient as well as outpatient dispensing for up to three days to facilitate linkage to treatment.

The Evaluation of a Clinical Decision Support Tool Using Natural Language Processing to Screen Hospitalized Adults for Unhealthy Substance Use: Protocol for a Quasi-Experimental Design.

Background: Automated and data-driven methods for screening using natural language processing (NLP) and machine learning may replace resource-intensive manual approaches in the usual care of patients hospitalized with conditions related to unhealthy substance use. The rigorous evaluation of tools that use artificial intelligence (AI) is necessary to demonstrate effectiveness before system-wide implementation. An NLP tool to use routinely collected data in the electronic health record was previously validated for diagnostic accuracy in a retrospective study for screening unhealthy substance use.

The substance use intervention team: A hospital-based intervention and outpatient clinic to improve care for patients with substance use disorders.

Purpose: In response to the opioid crisis, public health advocates urge hospitals to perform substance use disorder (SUD) screening, brief intervention, discharge planning with referral to treatment, and naloxone education. Universal screening makes specialized treatment available to all patients and decreases stigma around SUDs, allowing patients and providers to address SUDs during their hospitalization. Additionally, hospital and emergency department-initiated medications to treat SUD improve patient engagement with treatment and decrease opioid use, and use of medications for opioid use disorder after nonfatal overdoses decreases mortality.