Routine, coordinated treatment of opioid abuse can stem national epidemic

To help stem the nationwide opioid epidemic and related increases in HIV, hepatitis C and other infections, health care providers should routinely screen and treat patients for opioid abuse when they come to clinics and hospitals seeking other services.

That’s one of five recommendations outlined in a paper published in the Annals of Internal Medicine. The paper supports a newly published document that outlines the proceedings of a March 12, 2018, workshop convened on the topic by the National Academies of Sciences, Engineering and Medicine.

“Treatment can save lives,” said one of the paper’s authors, Todd Korthuis, M.D., M.P.H. “The national opioid epidemic can turn around if we embrace opioid use disorder as a chronic medical condition that needs treatment instead of a moral issue or the result of poor willpower.”

Korthuis, who is a professor of medicine (general internal medicine and geriatrics) and head of addiction medicine in the OHSU School of Medicine, also participated in the National Academies workshop and reviewed the resulting proceedings document. He co-wrote the paper with Sandra A. Springer, M.D., of the Yale School of Medicine and Carlos del Rio, M.D., of the Emory University School of Medicine, both of whom also participated in the workshop.

The workshop highlighted one of the many dire consequences of the opioid epidemic: more people are turning to injection drug use after their opioid prescriptions are cut off, which in turn has led to an increase in life-threatening infections of the skin, joint, blood, bone and more. These serious infections require expensive and lengthy hospital treatments, but most hospital staff don’t regularly address the root cause: drug addiction.

OHSU is one of a few U.S. hospitals that already routinely screens and treats patients for opioid abuse when they come to OHSU for other services. Opioid use disorder treatment at OHSU is initiated through a novel service called Project IMPACT, or Improving Addiction Care Team, in which physicians, social workers, peer-recovery mentors and others meet with hospitalized patients who have drug use issues and begin addiction treatment during hospitalization. Honora Englander, M.D., an associate professor of medicine (hospital medicine) in the OHSU School of Medicine, presented Project IMPACT at the National Academies workshop.

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