Support for Hospital Opioid Use Treatment (Project SHOUT)
February 22, 2018
Patients with opioid use disorder (OUD) are frequently hospitalized due to complications of the condition without also receiving treatment for the underlying disease of opioid addiction. This is a missed opportunity and leaves patients at high risk of future overdose. These hospitalizations are an ideal time to start medication-assisted treatment for addiction and to connect patients to ongoing outpatient services.
Two key treatments for opioid use disorder — buprenorphine and methadone — have been proven to cut overdose rates by two-thirds, lower HIV infections, and reduce criminal behavior. As many as 70% of patients are still in treatment after one year, compared to 6% of patients receiving treatment without these medications. However, when patients being treated with buprenorphine or methadone are hospitalized, these medications are often discontinued, increasing the risk of relapse to opioid use.
This program — Support for Hospital Opioid Use Treatment (Project SHOUT) — provides clinical leaders with the tools they need to start and maintain patients on buprenorphine or methadone during hospitalizations for any condition, be it medical, surgical, or obstetric. Specialists from the University of California, San Francisco, provide a range of supporting materials and events, including coaching, toolkits, protocols, monographs for pharmacy and therapeutics committees, and on-site presentations. In early 2018, SHOUT concluded a series of seven webinars about the implementation of opioid agonist therapy in the hospital setting.