Seaberg David C, McKinnon Jamie, Haselton Lyn, Reuter Quentin, Kolb Jason, Vellanki Suman, Morah J Chika, Oskvarek Jonathan, Jouriles Nicholas
Department of Emergency Medicine, Summa Health System, Akron, Ohio, USA.
Department of Psychiatry, Northeast Ohio Medical University, Rootstown, Ohio, USA.
J Am Coll Emerg Physicians Open. 2025 Jun 3;6(4):100192. doi: 10.1016/j.acepjo.2025.100192. eCollection 2025 Aug.
Medication for opioid use disorder (MOUD) programs are effective in treating opioid use disorder (OUD). Successful programs are resource-intensive. We describe our 5-year emergency department (ED)-based MOUD program results.
Our MOUD program uses Addiction Care Coordinators to coordinate care for OUD patients presenting to our ED. Peer recovery specialists provide counseling. Our MOUD program is available daily at our 2 hospitals. In 2021, we expanded our MOUD program to our 2 free-standing EDs using a telemedicine platform. Outcomes included the number of patients inducted over 5 years (2019-2023), the number inducted through telehealth, and the retention rate in the MOUD outpatient program at 1 and 6 months.
All 373,797 ED patients were screened for OUD over the 5 years, and 1072 (2.8%) were inducted into the MOUD program. A total of 53 patients (4.9%) were inducted through telemedicine. The number of patients inducted declined yearly; however, inpatient admissions for OUD declined less. The overall retention rate was 36.5% at 1 month and 28.8% at 6 months and then declined yearly. According to state data, the number of opioid and buprenorphine prescriptions also went down during this 5-year period.
ED-based MOUD programs expand access to treatment for patients with OUD. Patients' use of the ED-based MOUD program has declined each year, and retention rates have fallen. Several factors could be involved, such as increased strength of fentanyl, worsening withdrawal symptoms, increased inpatient admissions, and expansion of MOUD to community sites. Cost-effective strategies are needed to continue these programs.
阿片类物质使用障碍药物治疗（MOUD）项目在治疗阿片类物质使用障碍（OUD）方面是有效的。成功的项目需要大量资源。我们描述了我们基于急诊科（ED）的为期5年的MOUD项目成果。
我们的MOUD项目利用成瘾护理协调员为到我们急诊科就诊的OUD患者协调护理。同伴康复专家提供咨询。我们的MOUD项目在我们的两家医院每天都可提供。2021年，我们使用远程医疗平台将MOUD项目扩展到我们的两家独立急诊科。结果包括5年（2019 - 2023年）期间纳入的患者数量、通过远程医疗纳入的患者数量以及MOUD门诊项目在1个月和6个月时的留存率。
在这5年中，对所有373,797名急诊科患者进行了OUD筛查，1072名（2.8%）患者被纳入MOUD项目。共有53名患者（4.9%）通过远程医疗纳入。每年纳入的患者数量有所下降；然而，OUD的住院人数下降幅度较小。总体留存率在1个月时为36.5%，在6个月时为28.8%，随后逐年下降。根据州数据，在这5年期间，阿片类药物和丁丙诺啡的处方数量也有所下降。
基于急诊科的MOUD项目扩大了OUD患者获得治疗的机会。患者对基于急诊科的MOUD项目的使用逐年下降，留存率也在下降。可能涉及几个因素，如芬太尼效力增强、戒断症状加重、住院人数增加以及MOUD项目扩展到社区场所。需要具有成本效益的策略来继续这些项目。
