April 22, 2025

Adults who were hospitalized with opioid use disorders (OUD) who received addiction-focused consultation services were more likely to start medications for opioid use disorders (MOUD) during the hospitalization than those who did not receive those services. Among those who received the consultation, 57.3% started treatment with methadone, buprenorphine, or naltrexone, and 72.0% accessed follow-up care. Among those who did not receive the consultation, 26.7% initiated MOUD, and 48.1% accessed follow-up care that included MOUD plus psychosocial treatment. Those who received the consultation and intervention were nearly twice as likely to have an OUD-related discharge plan in their medical record, at 49.4% compared to 27.3% of those who received usual care.

The difference in OUD treatment outcomes was noted in a clinical trial that tested the Substance Use Treatment and Recovery Team (START) addiction-focused consultation model against hospital care without it. The model is delivered by a two-member team that includes an addiction medicine specialist and a care manager. Elements of the approach include:

• Participants receive diagnostic assessments
• Clinical recommendations are offered
• Discharge plans facilitate linkage to additional treatment, based on the individual’s substance use
• Follow-up telephone calls are included for one month after discharge.
• The team uses a manualized intervention based on motivational interviewing and focused discharge planning.

Those receiving care from START in the hospital and undergoing follow-up calls for a month after discharge were more likely to initiate or continue medication treatment after discharge (52.4%) compared to those who received usual care (30.8%). They were also more likely to see a health care professional for their OUD after discharge (34.4%) than those who did not receive a START consultation (18.3%).

These findings were presented in “Hospital Addiction Consultation Service and Opioid Use Disorder Treatment,” by Allison J. Ober, Ph.D.; Cristina Murray-Krezan, Ph.D.; Kimberly Page, Ph.D., MPH; Peter D. Friedmann, M.D., MPH; and colleagues. They conducted a randomized clinical trial of START involving 325 adults with OUD who were admitted to one of the three participating hospitals. The hospitals were located in Los Angeles, California; Albuquerque, New Mexico; and Springfield, Massachusetts. The goal was to test the impact of START consultation and intervention during hospitalization on MOUD initiation during hospitalization and linkage to post-discharge treatment for OUD.

The full text of “Hospital Addiction Consultation Service and Opioid Use Disorder Treatment” was published March 24, 2025, by JAMA Internal Medicine. A free copy is available online at https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2832101 (accessed April 17, 2025).