The Role of Hospitalists in Addressing the Opioid Crisis
Hospitalists should be educated on monitoring withdrawal, starting opioid agonist therapy, and identifying outpatient providers who can continue treatment.
HealthDay News — Hospitalists have an important role to play in mitigating opioid use disorder (OUD), according to an article published online in the Annals of Internal Medicine.
Noting that the number of individuals with OUD is increasing and therefore that a hospitalist's caseload includes an increasing number of patients with OUD and those admitted for opioid overdose or long-term therapy, Pooja Lagisetty, MD, and Amy Bohnert, PhD, from the University of Michigan and the VA Center for Clinical Management Research in Ann Arbor, discuss the role of hospitalists in addressing the growing opioid crisis.
The researchers note that hospitalists must use opioids judiciously, including adhering to specific dose limits and setting expectations for pain control, medication stop dates, and refills. A clear plan should be in place for safe disposal of medications and an effort to enact tapering plans for patients with chronic pain.
Screening with a patient-reported scale should be implemented to detect OUD; once it is recognized, hospitalists should initiate evidence-based treatment. Hospitalists should be educated on monitoring withdrawal, starting opioid agonist therapy, and identifying outpatient providers who can continue treatment.
"Hospitalists can no longer be bystanders to the sea change in opioid treatment practices," the authors write. "Just as they have always done, hospitalists must embrace this challenge and lead change in health care delivery during this growing epidemic."
Lagisetty P, Bohnert A. Annals for hospitalists inpatient notes - The opioid epidemic—what's a hospitalist to do? Ann Intern Med. 2017;167(2):HO2-HO3.