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Implementation of a Medication for Addiction Treatment (MAT) and Linkage Program by Leveraging Community Partnerships and Medical Toxicology Expertise.
J Med Toxicol. 2021 04; 17(2):176-184.JM

Abstract

INTRODUCTION

Implementing a hospital medication for addiction treatment (MAT) and a linkage program can improve care for patients with substance use disorder (SUD); however, lack of hospital funding and brick and mortar SUD resources are potential barriers to feasibility.

METHODS

This study assesses the feasibility of implementation of a SUD linkage program. Components of the program include a county-funded hospital opioid support team (HOST), a hospital-employed addiction recovery specialist (ARS), and a medical toxicology MAT induction service and maintenance program. Data for linkage by HOST, ARS, and MAT program were tracked from July 2018 to December 2019.

RESULTS

From July 2018 through December 2019, 1834 patients were linked to treatment: 1536 by HOST and 298 by the ARS. The most common disposition categories for patients linked by HOST were 16.73% to medically monitored detoxification, 9.38% to intensive outpatient, and 8.59% to short-term residential treatment. Among patients linked by the ARS, 65.66% were linked to outpatient treatment and 9.43% were linked directly to inpatient treatment. A total of 223 patients managed by the ARS were started on MAT by medical toxicology and linked to outpatient MAT clinic: 72.68% on buprenorphine/naloxone, 24.59% on naltrexone, 1.09% buprenorphine, and 0.55% acamprosate.

CONCLUSION

Implementing a MAT and linkage program in the ED and hospital setting was feasible. Leveraging medical toxicology expertise as well as community and funding partnerships was crucial to successful implementation.

Links

Authors+Show Affiliations

Department of Emergency and Hospital Medicine, Lehigh Valley Health Network/University of South Florida (USF) Morsani College of Medicine, Cedar Crest Blvd & I-78, Allentown, PA, 18103, USA. Gillian.Beauchamp@lvhn.org. Department of Emergency and Hospital Medicine, Division of Medical Toxicology, Lehigh Valley Health Network/University of South Florida (USF) Morsani College of Medicine, Cedar Crest Blvd & I-78, Allentown, PA, 18103, USA. Gillian.Beauchamp@lvhn.org.

Department of Emergency and Hospital Medicine, Lehigh Valley Health Network/University of South Florida (USF) Morsani College of Medicine, Cedar Crest Blvd & I-78, Allentown, PA, 18103, USA.

Department of Emergency and Hospital Medicine, Lehigh Valley Health Network/University of South Florida (USF) Morsani College of Medicine, Cedar Crest Blvd & I-78, Allentown, PA, 18103, USA.

Department of Emergency and Hospital Medicine, Lehigh Valley Health Network/University of South Florida (USF) Morsani College of Medicine, Cedar Crest Blvd & I-78, Allentown, PA, 18103, USA.

Department of Emergency and Hospital Medicine, Lehigh Valley Health Network/University of South Florida (USF) Morsani College of Medicine, Cedar Crest Blvd & I-78, Allentown, PA, 18103, USA.

Department of Emergency and Hospital Medicine, Lehigh Valley Health Network/University of South Florida (USF) Morsani College of Medicine, Cedar Crest Blvd & I-78, Allentown, PA, 18103, USA.

Department of Emergency and Hospital Medicine, Lehigh Valley Health Network/University of South Florida (USF) Morsani College of Medicine, Cedar Crest Blvd & I-78, Allentown, PA, 18103, USA.

Air Products Center for Connected Care and Innovation, Lehigh Valley Health Network, Allentown, PA, USA.

Department of Community Health, Lehigh Valley Health Network, Allentown, PA, USA.

Department of Emergency and Hospital Medicine, Lehigh Valley Health Network/University of South Florida (USF) Morsani College of Medicine, Cedar Crest Blvd & I-78, Allentown, PA, 18103, USA.

MeSH

AdultBuprenorphineFemaleHumansInterprofessional RelationsMaleMethadoneMiddle AgedNaltrexoneOpiate Substitution TreatmentOpioid-Related DisordersPatient Care TeamUnited States

Pub Type(s)

Journal Article

Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33146875

Citation

Beauchamp, Gillian A., et al. "Implementation of a Medication for Addiction Treatment (MAT) and Linkage Program By Leveraging Community Partnerships and Medical Toxicology Expertise." Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology, vol. 17, no. 2, 2021, pp. 176-184.

Beauchamp GA, Laubach LT, Esposito SB, et al. Implementation of a Medication for Addiction Treatment (MAT) and Linkage Program by Leveraging Community Partnerships and Medical Toxicology Expertise. J Med Toxicol. 2021;17(2):176-184.

Beauchamp, G. A., Laubach, L. T., Esposito, S. B., Yazdanyar, A., Roth, P., Lauber, P., Allen, J., Boateng, N., Shaak, S., & Burmeister, D. B. (2021). Implementation of a Medication for Addiction Treatment (MAT) and Linkage Program by Leveraging Community Partnerships and Medical Toxicology Expertise. Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology, 17(2), 176-184. https://doi.org/10.1007/s13181-020-00813-4

Beauchamp GA, et al. Implementation of a Medication for Addiction Treatment (MAT) and Linkage Program By Leveraging Community Partnerships and Medical Toxicology Expertise. J Med Toxicol. 2021;17(2):176-184. PubMed PMID: 33146875.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - Implementation of a Medication for Addiction Treatment (MAT) and Linkage Program by Leveraging Community Partnerships and Medical Toxicology Expertise. AU - Beauchamp,Gillian A, AU - Laubach,Lexis T, AU - Esposito,Samantha B, AU - Yazdanyar,Ali, AU - Roth,Paige, AU - Lauber,Priyanka, AU - Allen,Jamie, AU - Boateng,Nathan, AU - Shaak,Samantha, AU - Burmeister,David B, Y1 - 2020/11/04/ PY - 2020/06/16/received PY - 2020/09/14/accepted PY - 2020/09/09/revised PY - 2020/11/5/pubmed PY - 2021/11/18/medline PY - 2020/11/4/entrez KW - Emergency medicine KW - Medical toxicology KW - Medication for addiction treatment KW - Substance use disorder SP - 176 EP - 184 JF - Journal of medical toxicology : official journal of the American College of Medical Toxicology JO - J Med Toxicol VL - 17 IS - 2 N2 - INTRODUCTION: Implementing a hospital medication for addiction treatment (MAT) and a linkage program can improve care for patients with substance use disorder (SUD); however, lack of hospital funding and brick and mortar SUD resources are potential barriers to feasibility. METHODS: This study assesses the feasibility of implementation of a SUD linkage program. Components of the program include a county-funded hospital opioid support team (HOST), a hospital-employed addiction recovery specialist (ARS), and a medical toxicology MAT induction service and maintenance program. Data for linkage by HOST, ARS, and MAT program were tracked from July 2018 to December 2019. RESULTS: From July 2018 through December 2019, 1834 patients were linked to treatment: 1536 by HOST and 298 by the ARS. The most common disposition categories for patients linked by HOST were 16.73% to medically monitored detoxification, 9.38% to intensive outpatient, and 8.59% to short-term residential treatment. Among patients linked by the ARS, 65.66% were linked to outpatient treatment and 9.43% were linked directly to inpatient treatment. A total of 223 patients managed by the ARS were started on MAT by medical toxicology and linked to outpatient MAT clinic: 72.68% on buprenorphine/naloxone, 24.59% on naltrexone, 1.09% buprenorphine, and 0.55% acamprosate. CONCLUSION: Implementing a MAT and linkage program in the ED and hospital setting was feasible. Leveraging medical toxicology expertise as well as community and funding partnerships was crucial to successful implementation. SN - 1937-6995 UR - https://www.unboundmedicine.com/medline/citation/33146875/Implementation_of_a_Medication_for_Addiction_Treatment__MAT__and_Linkage_Program_by_Leveraging_Community_Partnerships_and_Medical_Toxicology_Expertise_ DB - PRIME DP - Unbound Medicine ER -