Treat Patients with Addiction During and After Hospitalization

The results of a new study demonstrate that starting hospitalized patients who have an opioid (heroin) addiction on buprenorphine treatment in the hospital and seamlessly connecting them with an outpatient office based treatment program can greatly reduce whether they relapse after they are discharged.

The study shows the important role that providers play in offering these patients addiction treatment both while in the hospital and after – even if their primary reason for being in the hospital is not for their addiction.

In the study 139 hospitalized individuals with opioid addiction, who were not already in treatment, were randomized into two groups. One group received a tapered dose treatment of buprenorphine for withdrawal and referral information about community treatment programs and the other were initiated on buprenorphine, an opioid substitute proven to treat opioid addiction, along with referral to a primary care office-based buprenorphine treatment program. Buprenorphine, which was approved by the Food and Drug Administration in 2002 for the treatment of opioid addiction, is taken orally and helps to curb opioid withdrawal symptoms.

Of those in the buprenorphine maintenance group, more than one third (37 percent) reported no illicit opioid/drug use for the month after they left the hospital compared to less than one in ten (nine percent) among the control group. These patients also reported, on average, fewer days of illicit drug use and continued to use less over the following six months. This effect was evident despite the fact that these patients did not initially come to the hospital seeking treatment for their addiction.

“Unfortunately, referral to substance abuse treatment after discharge is often a secondary concern of physicians caring for hospitalized patients,” said corresponding author Jane Liebschutz, MD, MPH, associate professor of medicine at BU School of Medicine and internist at Boston Medical Center. “However, our results show that we can have a marked impact on patient’s addiction by addressing it during their hospitalization.”

This study, which is published in JAMA – Internal Medicine, was done in collaboration with Butler Hospital in Rhode Island. Funding for this study was provided in part by the National Institute on Drug Abuse.