A Cost Model for a Low-Threshold Clinic Treating Opioid Use Disorder.

The US fee-for-service payment system under-reimburses clinics offering access to comprehensive treatments for opioid use disorder (OUD). The funding shortfall limits a clinic's ability to expand and improve access, especially for socially marginalized patients with OUD. New payment models, however, should reflect the high variation in cost for using a clinic's clinical and voluntary psychosocial and recovery support services.

Peer recovery coaches in general medical settings: Changes in utilization, treatment engagement, and opioid use.

Recovery coaches, trained peers with a history of substance use disorder (SUD) who are formally embedded in the health care team, may be a cost-effective approach to support outpatient management of SUD treatment. Although recovery coach programs are scaling nationwide, limited data exist to support their impact on costs or clinical outcomes. This study aimed to evaluate the integration of peer recovery coaches in general medical settings.

The effectiveness of post-discharge navigation added to an inpatient addiction consultation for patients with substance use disorder; a randomized controlled trial.

It is unknown whether post-discharge navigation enhances the impact of hospital-initiated addiction care. This study tested the incremental benefit of telephonic linkage to a post-discharge navigator for patients who received an addiction consultation during hospitalization. A two-arm, randomized controlled trial of 395 hospitalized adults with substance use disorder who received an addiction consultation.

The prevalence of unhealthy alcohol and drug use among inpatients in a general hospital.

Unhealthy substance use is a growing public health issue. Intersections with the health care system offer an opportunity for intervention; however, recent estimates of prevalence for unhealthy substance use among all types of hospital inpatients are unknown. Universal screening for unhealthy alcohol or drug use was implemented across a 999-bed general hospital between January 1 and December 31, 2015.

Effect of Integrating Substance Use Disorder Treatment into Primary Care on Inpatient and Emergency Department Utilization.

Background: Components of substance use disorder (SUD) treatment have been shown to reduce inpatient and emergency department (ED) utilization. However, integrated treatment using pharmacotherapy and recovery coaches in primary care has not been studied.

Objective: To determine whether integrated addiction treatment in primary care reduces inpatient and ED utilization and improves outpatient engagement.

Inpatient Addiction Consultation for Hospitalized Patients Increases Post-Discharge Abstinence and Reduces Addiction Severity.

Background: Alcohol and drug use results in substantial morbidity, mortality, and cost. Individuals with alcohol and drug use disorders are overrepresented in general medical settings. Hospital-based interventions offer an opportunity to engage with a vulnerable population that may not otherwise seek treatment.