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Reachable Moment: Hospital-Based Interventions

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Treating Opioid Use Disorder in General Medical Settings

Abstract

Patients with opioid use disorder (OUD) frequently utilize high-cost hospital services and have had rising rates of morbidity and mortality in the past two decades. Patients with OUD frequently experience untreated withdrawal and other poor hospital-related outcomes. Further, hospitalization is an often-missed reachable moment to engage patients with OUD in harm reduction services and to begin treatment, including medications for opioid use disorder (MOUD). This chapter outlines various strategies and current best practices, including formal interdisciplinary addiction consult services, which can be used to engage and treat hospitalized patients with OUD. In addition, this chapter addresses some of the ongoing challenges in providing high-quality care to inpatients with OUD, including stigma, structural barriers, and commonly held myths, all of which impede optimal care for these patients.

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References

  1. Ronan MV, Herzig SJ. Hospitalizations related to opioid abuse/dependence and associated serious infections increased sharply, 2002–12. Health Aff (Millwood). 2016;35(5):832–7.

    Article  Google Scholar 

  2. Agency for Healthcare Research and Quality. Statistical Brief #249. Healthcare Cost and Utilization Project (HCUP). [Internet]. 2019 [cited 2019 Jul 8]. Available from: www.hcup-us.ahrq.gov/reports/statbriefs/sb249-Mental-Substance-Use-Disorder-Hospital-Stays-2016.jsp?utm_source=ahrq&utm_medium=en1&utm_term=Stats&utm_content=1&utm_campaign=ahrq_en6_11_2019.

  3. U.S. Census Bureau, Population Division. Annual estimates of the resident population by sex, age, race, and Hispanic origin for the United States and States: April 1, 2010, to July 1, 2018 [Internet]. 2019 [cited 2019 Nov 25]. Available from: https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=bkmk.

  4. Ciccarone D, Unick GJ, Cohen JK, Mars SG, Rosenblum D. Nationwide increase in hospitalizations for heroin-related soft tissue infections: associations with structural market conditions. Drug Alcohol Depend. 2016;163:126–33.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Gray ME, Rogawski McQuade ET, Scheld WM, Dillingham RA. Rising rates of injection drug use associated infective endocarditis in Virginia with missed opportunities for addiction treatment referral: a retrospective cohort study. BMC Infect Dis [Internet]. 2018 [cited 2018 Dec 17];18. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6201507/.

  6. Wurcel AG, Anderson JE, Chui KKH, Skinner S, Knox TA, Snydman DR, et al. Increasing infectious endocarditis admissions among young people who inject drugs. Open Forum Infect Dis. 2016;3(3):ofw157.

    Google Scholar 

  7. Song Z. Mortality quadrupled among opioid-driven hospitalizations, notably within lower-income and disabled white populations. Health Aff (Millwood). 2017;36(12):2054–61.

    Article  Google Scholar 

  8. Wakeman SE, Pham-Kanter G, Donelan K. Attitudes, practices, and preparedness to care for patients with substance use disorder: results from a survey of general internists. Subst Abuse. 2016;37(4):635–41.

    Article  Google Scholar 

  9. Jicha C, Saxon D, Lofwall MR, Fanucchi LC. Substance use disorder assessment, diagnosis, and management for patients hospitalized with severe infections due to injection drug use. J Addict Med. 2019;13(1):69.

    Article  PubMed  Google Scholar 

  10. Rosenthal ES, Karchmer AW, Theisen-Toupal J, Castillo RA, Rowley CF. Suboptimal addiction interventions for patients hospitalized with injection drug use-associated infective endocarditis. Am J Med. 2016;129(5):481–5.

    Article  PubMed  Google Scholar 

  11. Reif S, Acevedo A, Garnick DW, Fullerton C. Reducing behavioral inpatient readmissions for people with substance use disorders: do follow-up services matter? Psychiatr Serv (Washington, DC). 2017;68(8):810–8.

    Article  Google Scholar 

  12. Larochelle MR, Bernstein R, Bernson D, Land T, Stopka TJ, Rose AJ, et al. Touchpoints – opportunities to predict and prevent opioid overdose: a cohort study. Drug Alcohol Depend. 2019;204:107537.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Larochelle MR, Bernson D, Land T, Stopka TJ, Wang N, Xuan Z, et al. Medication for opioid use disorder after nonfatal opioid overdose and association with mortality: a cohort study. Ann Intern Med. 2018;169(3):137.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Priest KC, Lovejoy TI, Englander H, Shull S, McCarty D. Opioid agonist therapy during hospitalization within the Veterans Health Administration: a pragmatic retrospective cohort analysis. J Gen Intern Med. 2020;35:2365–74.

    Article  PubMed  PubMed Central  Google Scholar 

  15. King C, Nicolaidis C, Korthuis PT, Priest KC, Englander H. Patterns of substance use before and after hospitalization among patients seen by an inpatient addiction consult service: a latent transition analysis. J Subst Abus Treat. 2020;118:108121.

    Article  Google Scholar 

  16. Englander H, Dobbertin K, Lind BK, Nicolaidis C, Graven P, Dorfman C, et al. Inpatient addiction medicine consultation and post-hospital substance use disorder treatment engagement: a propensity-matched analysis. J Gen Intern Med. 2019;34(12):2796–803.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Wakeman SE, Metlay JP, Chang Y, Herman GE, Rigotti NA. Inpatient addiction consultation for hospitalized patients increases post-discharge abstinence and reduces addiction severity. J Gen Intern Med. 2017;19:1–8.

    Google Scholar 

  18. Collins D, Alla J, Nicolaidis C, Gregg J, Gullickson DJ, Patten A, et al. “If it wasn’t for him, I wouldn’t have talked to them”: qualitative study of addiction peer mentorship in the hospital. J Gen Intern Med [Internet]. 2019 [cited 2019 Nov 21]; Available from: https://doi.org/10.1007/s11606-019-05311-0.

  19. Hyshka E, Morris H, Anderson-Baron J, Nixon L, Dong K, Salvalaggio G. Patient perspectives on a harm reduction-oriented addiction medicine consultation team implemented in a large acute care hospital. Drug Alcohol Depend. 2019;204:107523.

    Article  PubMed  Google Scholar 

  20. Englander H, Collins D, Perry SP, Rabinowitz M, Phoutrides E, Nicolaidis C. “We’ve learned it’s a medical illness, not a moral choice”: qualitative study of the effects of a multicomponent addiction intervention on hospital providers’ attitudes and experiences. J Hosp Med. 2018;13:752–8.

    PubMed  Google Scholar 

  21. Substance Abuse and Mental Health Services Administration. TIP 63: medications for opioid use disorder [internet]. Rockville: Substance Abuse and Mental Health Services Administration; 2018 [cited 2019 Nov 30]. Available from: https://store.samhsa.gov/product/TIP-63-Medications-for-Opioid-Use-Disorder-Full-Document-Including-Executive-Summary-and-Parts-1-5-/SMA19-5063FULLDOC.

  22. Wakeman SE, Herman G, Wilens TE, Regan S. The prevalence of unhealthy alcohol and drug use among inpatients in a general hospital. Subst Abuse. 2019;1:1–9.

    Google Scholar 

  23. Englander H, Weimer M, Solotaroff R, Nicolaidis C, Chan B, Velez C, et al. Planning and designing the Improving Addiction Care Team (IMPACT) for hospitalized adults with substance use disorder. J Hosp Med. 2017;12(5):339–42.

    Article  PubMed  Google Scholar 

  24. Velez CM, Nicolaidis C, Korthuis PT, Englander H. “It’s been an experience, a life learning experience”: a qualitative study of hospitalized patients with substance use disorders. J Gen Intern Med. 2017;32(3):296–303.

    Article  PubMed  Google Scholar 

  25. Botticelli M, Gottlieb M, Laderman M. Institute for healthcare improvement: effective strategies for hospitals responding to the opioid crisis [Internet]. Institute for Healthcare Improvement and the Grayken Center for Addiction at Boston Medical Center; 2019 [cited 2019 Nov 25]. Available from: http://www.ihi.org:80/resources/Pages/Publications/Effective-Strategies-for-Hospitals-Responding-to-Opioid-Crisis.aspx.

  26. National Committee for Quality Assurance. Initiation and engagement of alcohol and other drug abuse or dependence treatment [Internet]. NCQA. 2019 [cited 2019 Nov 25]. Available from: https://www.ncqa.org/hedis/measures/initiation-and-engagement-of-alcohol-and-other-drug-abuse-or-dependence-treatment/.

  27. McNeil R, Small W, Wood E, Kerr T. Hospitals as a ‘risk environment’: an ethno-epidemiological study of voluntary and involuntary discharge from hospital against medical advice among people who inject drugs. Soc Sci Med. 2014;105:59–66.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Zhu H, Wu L-T. Discharge against medical advice from hospitalizations for substance use disorders: the potential impact of the Affordable Care Act. Drug Alcohol Depend. 2019;197:115–9.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Liebschutz JM, Crooks D, Herman D, et al. Buprenorphine treatment for hospitalized, opioid-dependent patients: a randomized clinical trial. JAMA Intern Med. 2014;174(8):1369–76.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  30. Noska A, Mohan A, Wakeman S, Rich J, Boutwell A. Managing opioid use disorder during and after acute hospitalization: a case-based review clarifying methadone regulation for acute care settings. J Addict Behav Ther Rehabil. 2015;4(2).

    Google Scholar 

  31. Pytell JD, Sharfstein JM, Olsen Y. Facilitating methadone use in hospitals and skilled nursing facilities. JAMA Intern Med [Internet]. 2019 [cited 2019 Nov 20]; Available from: https://jamanetwork-com.ezproxy.bu.edu/journals/jamainternalmedicine/fullarticle/2754811.

  32. Substance Abuse and Mental Health Services Administration. Special circumstances for providing buprenorphine [Internet]. 2016 [cited 2019 Dec 2]. Available from: https://www.samhsa.gov/medication-assisted-treatment/legislation-regulations-guidelines/special.

  33. Joseph H, Stancliff S, Langrod J. Methadone maintenance treatment (MMT): a review of historical and clinical issues. Mt Sinai J Med. 2000;67:18.

    Google Scholar 

  34. Hemmons P, Bach P, Colizza K, Nolan S. Initiation and rapid titration of methadone in an acute care setting for the treatment of opioid use disorder: a case report. J Addict Med. 2019;13(5):408.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Kleber HD. Pharmacologic treatments for opioid dependence: detoxification and maintenance options. Dialogues Clin Neurosci. 2007;9(4):455–70.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Trowbridge P, Weinstein ZM, Kerensky T, Roy P, Regan D, Samet JH, et al. Addiction consultation services – linking hospitalized patients to outpatient addiction treatment. J Subst Abus Treat. 2017;79:1–5.

    Article  Google Scholar 

  37. Hämmig R, Kemter A, Strasser J, von Bardeleben U, Gugger B, Walter M, et al. Use of microdoses for induction of buprenorphine treatment with overlapping full opioid agonist use: the Bernese method. Subst Abus Rehabil. 2016;7:99–105.

    Article  Google Scholar 

  38. Terasaki D, Smith C, Calcaterra SL. Transitioning hospitalized patients with opioid use disorder from methadone to buprenorphine without a period of opioid abstinence using a microdosing protocol. Pharmacotherapy. 2019;39(10):1023–9.

    Article  CAS  PubMed  Google Scholar 

  39. Tang VM, Lam-Shang-Leen J, Brothers TD, Hansen K, Caudarella A, Lamba W, et al. Case series: limited opioid withdrawal with use of transdermal buprenorphine to bridge to sublingual buprenorphine in hospitalized patients. Am J Addict. 2020;29(1):73–6.

    Article  PubMed  Google Scholar 

  40. Raheemullah A, Lembke A. Initiating opioid agonist treatment for opioid use disorder in the inpatient setting: a teachable moment. JAMA Intern Med. 2019;179(3):427–8.

    Article  PubMed  Google Scholar 

  41. Ghosh SM, Klaire S, Tanguay R, Manek M, Azar P. A review of novel methods to support the transition from methadone and other full agonist opioids to buprenorphine/naloxone sublingual in both community and acute care settings. Can J Addict. 2019;10(4):41–50.

    Article  Google Scholar 

  42. Hess M, Boesch L, Leisinger R, Stohler R. Transdermal buprenorphine to switch patients from higher dose methadone to buprenorphine without severe withdrawal symptoms. Am J Addict. 2011;20(5):480–1.

    Article  PubMed  Google Scholar 

  43. Alford DP, Compton P, Samet JH. Acute pain management for patients receiving maintenance methadone or buprenorphine therapy. Ann Intern Med. 2006;144(2):127–34.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Hansen LE, Stone GL, Matson CA, Tybor DJ, Pevear ME, Smith EL. Total joint arthroplasty in patients taking methadone or buprenorphine/naloxone preoperatively for prior heroin addiction: a prospective matched cohort study. J Arthroplasty [Internet]. [cited 2016 May 4]; Available from: http://www.sciencedirect.com/science/article/pii/S0883540316000942.

  45. Vilkins AL, Bagley SM, Hahn KA, Rojas-Miguez F, Wachman EM, Saia K, et al. Comparison of post-cesarean section opioid analgesic requirements in women with opioid use disorder treated with methadone or buprenorphine. J Addict Med. 2017;11(5):397–401.

    Google Scholar 

  46. Lembke A, Ottestad E, Schmiesing C. Patients maintained on buprenorphine for opioid use disorder should continue buprenorphine through the perioperative period. Pain Med [Internet]. [cited 2018 Feb 21]; Available from: https://academic-oup-com.ezproxy.bu.edu/painmedicine/advance-article/doi/10.1093/pm/pny019/4858540.

  47. Lee JD, Nunes EV, Novo P, Bachrach K, Bailey GL, Bhatt S, et al. Comparative effectiveness of extended-release naltrexone versus buprenorphine-naloxone for opioid relapse prevention (X:BOT): a multicentre, open-label, randomised controlled trial. Lancet. 2018;391(10118):309–18.

    Article  CAS  PubMed  Google Scholar 

  48. Morgan JR, Schackman BR, Weinstein ZM, Walley AY, Linas BP. Overdose following initiation of naltrexone and buprenorphine medication treatment for opioid use disorder in a United States commercially insured cohort. Drug Alcohol Depend. 2019;200:34–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Priest KC, Englander H, McCarty D. “Now hospital leaders are paying attention”: a qualitative study of internal and external factors influencing addiction consult services. J Subst Abus Treat. 2020;110:59–65.

    Article  Google Scholar 

  50. U.S. Government. Code of federal regulations. Title 21, Part 1306 [Internet]. Electronic code of federal regulations June 23, 2005. Available from: https://www.ecfr.gov/cgi-bin/text-idx?SID=dd3324c93ad659b4a55e8cca8156a65c&node=se21.9.1306_107&rgn=div8.

  51. U.S. Department of Justice. Emergency narcotic addiction treatment [Internet]. [cited 2020 Oct 15]. Available from: https://www.deadiversion.usdoj.gov/pubs/advisories/emerg_treat.htm.

  52. Biancarelli DL, Biello KB, Childs E, Drainoni M, Salhaney P, Edeza A, et al. Strategies used by people who inject drugs to avoid stigma in healthcare settings. Drug Alcohol Depend. 2019;198:80–6.

    Article  PubMed  PubMed Central  Google Scholar 

  53. McNeil R, Kerr T, Pauly B, Wood E, Small W. Advancing patient-centered care for structurally vulnerable drug-using populations: a qualitative study of the perspectives of people who use drugs regarding the potential integration of harm reduction interventions into hospitals. Addiction. 2016;111(4):685–94.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Principles of Harm Reduction [Internet]. Harm reduction coalition. Available from: https://harmreduction.org/about-us/principles-of-harm-reduction/.

  55. Substance Abuse and Mental Health Services Administration. Trauma-informed care in behavioral health services. Treatment improvement protocol (TIP) series 57. HHS Publication No. (SMA) 13-4801. [Internet]. Substance Abuse and Mental Health Services Administration; 2014 [cited 2019 Dec 31]. Available from: https://store.samhsa.gov/product/TIP-57-Trauma-Informed-Care-in-Behavioral-Health-Services/SMA14-4816.

  56. Trauma Informed Oregon [Internet]. Trauma informed Oregon. [cited 2020 Oct 15]. Available from: https://traumainformedoregon.org/.

  57. Kimmel SD, Rosenmoss S, Bearnot B, Larochelle M, Walley AY. Rejection of patients with opioid use disorder referred for post-acute medical care before and after an anti-discrimination settlement in Massachusetts. J Addict Med. 2020;15:20–6.

    Article  Google Scholar 

  58. Wakeman SE, Rich JD. Barriers to post-acute care for patients on opioid agonist therapy: an example of systematic stigmatization of addiction. J Gen Intern Med. 2017;32(1):17–9.

    Article  PubMed  Google Scholar 

  59. Green TC, Clarke J, Brinkley-Rubinstein L, Marshall BDL, Alexander-Scott N, Boss R, et al. Postincarceration fatal overdoses after implementing medications for addiction treatment in a statewide correctional system. JAMA Psychiat. 2018;75(4):405–7.

    Article  Google Scholar 

  60. Ritvo AD, Calcaterra SL, Ritvo JI. Using extended release buprenorphine injection to discontinue sublingual buprenorphine: a case series. J Addict Med. 2020;15:252–4.

    Article  Google Scholar 

  61. Englander H, Wilson T, Collins D, Phoutrides E, Weimer M, Korthuis PT, et al. Lessons learned from the implementation of a medically enhanced residential treatment (MERT) model integrating intravenous antibiotics and residential addiction treatment. Subst Abuse. 2018 Mar 29;0(ja):1–25.

    Google Scholar 

  62. Appel PW, Oldak R. A preliminary comparison of major kinds of obstacles to enrolling in substance abuse treatment (AOD) reported by injecting street outreach clients and other stakeholders. Am J Drug Alcohol Abuse. 2007;33(5):699–705.

    Article  PubMed  Google Scholar 

  63. Merrill JO, Rhodes LA, Deyo RA, Marlatt GA, Bradley KA. Mutual mistrust in the medical care of drug users. J Gen Intern Med. 2002;17(5):327–33.

    PubMed  PubMed Central  Google Scholar 

  64. Kelly JF, Wakeman SE, Saitz R. Stop talking ‘dirty’: clinicians, language, and quality of care for the leading cause of preventable death in the United States. Am J Med. 2015;128(1):8–9.

    Article  PubMed  Google Scholar 

  65. Thakarar K, Weinstein ZM, Walley AY. Optimising health and safety of people who inject drugs during transition from acute to outpatient care: narrative review with clinical checklist. Postgrad Med J. 2016;postgradmedj-2015-133720.

    Google Scholar 

  66. Heller D, McCoy K, Cunningham C. An invisible barrier to integrating HIV primary care with harm reduction services: philosophical clashes between the harm reduction and medical models. Public Health Rep. 2004;119(1):32–9.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Appel PW, Ellison AA, Jansky HK, Oldak R. Barriers to enrollment in drug abuse treatment and suggestions for reducing them: opinions of drug injecting street outreach clients and other system stakeholders. Am J Drug Alcohol Abuse. 2004;30(1):129–53.

    Article  PubMed  Google Scholar 

  68. Korthuis PT, Gregg J, Rogers WE, McCarty D, Nicolaidis C, Boverman J. Patients’ reasons for choosing office-based buprenorphine: preference for patient-centered care. J Addict Med. 2010;4(4):204–10.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Masson CL, Sorensen JL, Grossman N, Sporer KA, Des Jarlais DC, Perlman DC. Organizational issues in the implementation of a hospital-based syringe exchange program. Subst Use Misuse. 2010;45(6):901–15.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Priest K, McCarty D. The role of hospitalists in treating opioid use disorder. J Addict Med [Internet]. 2019 [cited 2019 Nov 21];Publish Ahead of Print. Available from: insights.ovid.com.

  71. Gryczynski J, Schwartz RP, Salkever DS, Mitchell SG, Jaffe JH. Patterns in admission delays to outpatient methadone treatment in the United States. J Subst Abus Treat. 2011;41(4):431–9.

    Article  Google Scholar 

  72. Fisher DG, Reynolds GL, D’Anna LH, Hosmer DW, Hardan-Khalil K. Failure to get into substance abuse treatment. J Subst Abus Treat. 2017;73:55–62.

    Article  Google Scholar 

  73. D’Amico MJ, Walley AY, Cheng DM, Forman LS, Regan D, Yurkovic A, et al. Which patients receive an addiction consult? A preliminary analysis of the INREACH (INpatient REadmission post-Addiction Consult Help) study. J Subst Abus Treat. 2019;106:35–42.

    Article  Google Scholar 

  74. Englander H. A call to action: hospitalists’ role in addressing substance use disorder. J Hosp Med [Internet]. 2019 [cited 2019 Nov 21]; Available from: https://www.journalofhospitalmedicine.com/jhospmed/article/210071/hospital-medicine/call-action-hospitalists-role-addressing-substance-use.

  75. Wei J, Defries T, Lozada M, Young N, Huen W, Tulsky J. An inpatient treatment and discharge planning protocol for alcohol dependence: efficacy in reducing 30-day readmissions and emergency department visits. J Gen Intern Med. 2015;30(3):365–70.

    Article  PubMed  Google Scholar 

  76. Bottner R, Moriates C, Tirado C. The role of hospitalists in treating opioid use disorder. J Addict Med [Internet]. 2019 [cited 2020 Jan 27];Publish Ahead of Print. Available from: https://journals.lww.com/journaladdictionmedicine/Citation/publishahead/The_Role_of_Hospitalists_in_Treating_Opioid_Use.99349.aspx.

  77. Priest KC, McCarty D. Making the business case for an addiction medicine consult service: a qualitative analysis. BMC Health Serv Res [Internet]. 2019 [cited 2019 Nov 21];19. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6842195/.

  78. Thompson HM, Hill K, Jadhav R, Webb TA, Pollack M, Karnik N. The substance use intervention team: a preliminary analysis of a population-level strategy to address the opioid crisis at an academic health center. J Addict Med. 2019;13(6):460.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Mohlman MK, Tanzman B, Finison K, Pinette M, Jones C. Impact of medication-assisted treatment for opioid addiction on Medicaid expenditures and health services utilization rates in Vermont. J Subst Abus Treat. 2016;67:9–14.

    Article  Google Scholar 

  80. Ronquest NA, Willson TM, Montejano LB, Nadipelli VR, Wollschlaeger BA. Relationship between buprenorphine adherence and relapse, health care utilization and costs in privately and publicly insured patients with opioid use disorder. Subst Abus Rehabil. 2018;9:59–78.

    Article  Google Scholar 

  81. Kilaru AS, Perrone J, Kelley D, Siegel S, Lubitz SF, Mitra N, et al. Participation in a hospital incentive program for follow-up treatment for opioid use disorder. JAMA Netw Open. 2020;3(1):e1918511.

    Article  PubMed  PubMed Central  Google Scholar 

  82. Institute of Medicine (US) Committee on Crossing the Quality Chasm: Adaptation to Mental Health and Addictive Disorders. Improving the quality of health care for mental and substance-use conditions: Quality chasm series [Internet]. Washington (DC): National Academies Press (US); 2006 [cited 2016 Feb 29]. (The National Academies Collection: Reports funded by National Institutes of Health). Available from: http://www.ncbi.nlm.nih.gov/books/NBK19830/.

  83. Rico F, Liu Y, Martinez DA, Huang S, Zayas-Castro JL, Fabri PJ. Preventable readmission risk factors for patients with chronic conditions. J Healthc Qual. 2016;38(3):127–42.

    Google Scholar 

  84. Yanagawa B, Bahji A, Lamba W, Tan D, Cheema A, Syed I, et al. Endocarditis in the setting of IDU: multidisciplinary management. Curr Opin Cardiol. 2018;33(2):140–7.

    Article  PubMed  Google Scholar 

  85. Burris S, Vernick JS, Ditzler A, Strathdee S. The legality of selling or giving syringes to injection drug users. J Am Pharm Assoc (Washington, DC, 1996). 2002;42(6 Suppl 2):S13–18.

    Google Scholar 

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Authors and Affiliations

  1. General Internal Medicine, Boston University, Boston, MA, USA

    Zoe M. Weinstein

  2. Division of Hospital Medicine, Department of Medicine, Oregon Health & Science University, Portland, OR, USA

    Honora Englander

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  1. Department of Medicine, Massachusetts General Hospital, Charlestown, MA, USA

    Sarah E. Wakeman

  2. Brown University, The Miriam and Rhode Island Hospitals, Providence, RI, USA

    Josiah D. Rich

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Weinstein, Z.M., Englander, H. (2021). Reachable Moment: Hospital-Based Interventions. In: Wakeman, S.E., Rich, J.D. (eds) Treating Opioid Use Disorder in General Medical Settings. Springer, Cham. https://doi.org/10.1007/978-3-030-80818-1_4

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