THE CONTINUUM OF CARE IN HOSPITALIZED PATIENTS WITH OPIOID USE DISORDER AND INFECTIOUS COMPLICATIONS OF DRUG USE (CHOICE)

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In the United States, there is an opioid epidemic which is associated with acquisition of HIV, HCV and STIs, as well as rising rates of infective endocarditis and systemic bacterial infections.(1-3) Given the clear intersection of these parallel epidemics of infectious diseases and opioid use disorder, it is critical that we identify models of care which prevent acquisition of these infections and enhance treatment of existing infections by addressing opioid use disorder throughout the continuum of care.(4,5) Many individuals with opioid use disorder (OUD) are not engaged in medical care, therefore, inpatient hospitalization represents an opportune time to initiate treatment and engagement among these high risk individuals. However, inpatient interventions to address addiction are often suboptimal, incomplete, or limited to the time of hospitalization.(6) Further, observational investigations in individual hospital systems have demonstrated the effectiveness of interventions, including addiction consult teams, multidisciplinary rounds, and linkage navigators, in increasing uptake of medications for opioid use disorder during hospitalization and linkage into addictions treatment after discharge. However, there have been no multi-center investigations to rigorously evaluate the impact of these interventions on long term infectious outcomes. This study is part of the NIH’s Helping to End Addiction Long-term (HEAL) initiative to speed scientific solutions to the national opioid public health crisis. The NIH HEAL Initiative bolsters research across NIH to improve treatment for opioid misuse and addiction