Creation of an Inpatient Addiction Consult Team: Project Update and Lessons Learned

Individuals with opioid use disorder (OUD) are at risk for developing serious complications, including overdose, complex infections, and respiratory failure. In some occasions, this can lead to prolonged hospital stays, especially when there are concerns about prolonged antibiotic administration. Currently during these stays, patients are rarely treated for their addiction or worse, they encounter stigma that could have severe negative effects on their ongoing substance use and their ability to receive care in the future. In order to combat these concerns, we have created an inpatient addiction consult team (I-ACT) focused on people with an opioid use disorder with an inpatient stay at Prisma Health– Richland. This consult model follows many that have been implemented in hospital across the United States that are aimed at increasing outpatient substance use disorder treatment retention rates in individuals with OUD with inpatient hospital stays. I-ACT offers counselling services, advises on appropriate testing of comorbid conditions (e.g., HCV and HIV) and assesses for medication assisted treatment (MAT). If the patient is appropriate for MAT, the team will start medication and coordinate follow-up upon discharge. By treating addiction in the hospital, I-ACT aims to increase the success of addiction treatment as measured by retention in treatment at specified time points. We expect additional financial benefits through reduced hospital length of stay and reduced overall hospital expenditures. In the long term, we expect reduced readmission rates and mortality as more people receive appropriate treatment for addiction.