Addiction Medicine: Opioid Use Disorder and Hospital Medicine

Vision: People with OUD entering our nation’s hospitals will receive compassionate evidence-based trauma-informed medical care, benefiting from an ecosystem of care designed to meet their specific and individualized needs.

Mission: Our mission is to elevate the knowledge, skills and attitudes of hospitalists as generalists who provide care for people with OUD, and explore how hospitalists can best interact with and co-create effective systems of care for patients with OUD to improve safety, quality, cost, equity, patient experience, and provider wellbeing.

Values

• Individual people are at the center of the of the opioid crisis, thus the experiences, needs, preferences, and goals of people with OUD should be the north star of our work.
• “Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry dysfunction leading to characteristic biological, psychological, social and spiritual manifestations.”
• Knowledge, skills, and attitudes have been defined for hospitalists in the areas of addiction medicine and more specifically management of OUD, and it should be the goal of hospitalists to practice to the top of their licenses in this area.
• Managing OUD is intrinsically interprofessional and multidisciplinary. As such our work must be guided by mutual respect, partnership, and collaboration.

Alignment with HOMERuN Vision, Mission, & Values

Addiction Medicine is an emerging area of practice in Hospital Medicine.  Hospitalists have long been expected to diagnose and treat alcohol withdrawal and use disorder, as well as recognize the signs and symptoms of acute intoxication and withdrawal from a range of non-prescription substances.  However, disease complexity and morbidity are skyrocketing with the dominance of fentanyl in the American drug supply and the introduction of new adulturants including but not limited to xylazine. Required knowledge, skills, and attitudes are evolving rapidly with the shifts in the opioid epidemic, and the care landscape is unstable due to changes in policy, regulation, reimbursement, and infrastructure both internal and external to our hospitals and health systems.  Patients with OUD are some of the most vulnerable in our health systems, and our current care ecosystem is woefully insufficent at meeting their needs, as evidenced by high rates of Patient Directed Discharges, readmissions, perceived stigma, and mortality with evident racial and ethnic disparities.  Providers come to work daily feeling they lack the skills and support to meet patient’s needs, leading to moral distress and burnout.

The status quo of care for people with OUD must be transformed through innovation, evaluation, collaboration, and dissemination, aligning with HOMERuN’s strategic vision and mission.

• We will collaborate with addiction medicine leaders and community partners, using our collective voices to advance the culture and science of care for people who use drugs when their lives intersect with the acute care environment.
• Using our community to continually refine our understanding of the problems and challenges faced by patients and clinicians in regards to care of people with SUD in the hospital.

Collect and disseminate recommended practices, innovations, and operational solutions that improve care of people with SUD in the hospital, relevant to all hospitalists who care for people with SUD, as well as those specializing in SUD care.

Strategic Goals

Team
Rebecca Jaffe, MD; Thomas Jefferson Univeristy
[Co-Lead TBD]

Member names and institutions

• Rebecca Jaffe, MD, Thomas Jefferson University
• Noel Ivey, MD, Duke University
• Ryan Kell, MD, MS, University of Minnesota
• Cuong Pham, MD, University of Minnesota
• Ethan Kuperman, MD, University of Iowa
• Katherine Welter, MD, Northwestern University
• Alyssa Moller, MD, Washington University of St. Louis
• Benjamin Hoemann, MD, Washington University of St. Louis
• Dana Clifton, MD, Duke University
• Jeffrey Wunderlich, MD, University of Iowa
• Keri Holmes-Maybank, MD, Medical University of South Carolina
• John (JP) Murray, MD, University of Chicago
• Jillian Zavodnick, MD, Thomas Jefferson University
• Philip Durney, MD, Thomas Jefferson University
• Suparna Dutta, MD, MPH, FACP, SFHM, Hartford Health
• Hasan Naqvi, MD, MBA, University of Missouri Columbia
• Michael Rose, MD, MPH, Johns Hopkins Medicine
• Susan Calcaterra, MD, MPH/MSPH, MS, University of Colorado School of Medicine
• Catherine Callister, MD, University of Colorado School of Medicine