AI Article Synopsis
- The study explores a program in emergency departments (ED) that allows doctors to provide methadone as a temporary treatment for opioid addiction, aiming to improve access and linkage to ongoing care.
- In a review of patient encounters from January to August 2021, it was found that 91% of patients who received methadone as a "guest dose" continued treatment after leaving the ED, indicating a strong retention rate.
- The results suggest that ED-based methadone treatment can effectively bridge patients to opioid treatment programs, with certain factors like the chief complaint helping predict successful patient linkage to continued care.
Article Abstract
Study Objective: The "72-h rule" allows emergency department (ED) physicians to administer methadone as an induction or bridge while referring to treatment. We aimed to evaluate an ED-based program designed to increase methadone access.
Methods: We reviewed ED encounters involving methadone administration between January and August 2021. We characterized this cohort and examined the linkage and 30-day retention rates of patients linked to our partner opioid treatment program (OTP). We used logistic regression models to identify predictors of successful linkage and retention.
Results: Methadone was administered during 597 encounters with 300 unique patients. Patients presenting for a methadone dose had lengths of stay (LOS) comparable to other low acuity patients. Ninety-one percent of patients presenting for a "guest dose" continued treatment after discharge. 39 patients were initiated on methadone; 56 % completed linkage, and of those 100 % were in treatment at 30 days. A chief complaint of "methadone dose" was predictive of successful linkage and additional opioid requirement or a longer ED LOS was predictive of unsuccessful linkage.
Conclusions: ED-based methadone "guest dosing," initiation, and bridging with linkage to care can increase access to MOUD. Most patients were seen for "guest dosing," and the majority remained in treatment at 30 days. A small sample was initiated on methadone and discharged from the ED. In this limited group, initial linkage and 30-day retention rates were similar to those of inpatient methadone initiation and ED-based buprenorphine initiation. Further study of ED-based methadone initiation is warranted.
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| http://dx.doi.org/10.1016/j.ajem.2024.12.059 | DOI Listing |
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Article Synopsis
- The study explores a program in emergency departments (ED) that allows doctors to provide methadone as a temporary treatment for opioid addiction, aiming to improve access and linkage to ongoing care.
- In a review of patient encounters from January to August 2021, it was found that 91% of patients who received methadone as a "guest dose" continued treatment after leaving the ED, indicating a strong retention rate.
- The results suggest that ED-based methadone treatment can effectively bridge patients to opioid treatment programs, with certain factors like the chief complaint helping predict successful patient linkage to continued care.
State Medicaid Policies Governing Access to Medications for Opioid Use Disorder (MOUD) and MOUD Treatment Use in a Large Sample of People Who Inject Drugs in 20 U.S. States.
Subst Use Misuse
December 2024
Department of Health Policy and Management, Rollins School of Public Health at Emory University, Atlanta, GA, USA.
Background: People who inject drugs (PWID) are especially vulnerable to harms from opioid use disorder (OUD). Medications for OUD (MOUD) effectively reduce overdose and infectious disease transmission risks.
Objective: We investigate whether state Medicaid coverage for methadone and buprenorphine is related to past-year MOUD use among PWID using cross-sectional, multilevel analyses with individual-level data on PWID from the Centers for Disease Control and Prevention's 2018 National HIV Behavioral Surveillance.
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