Expert Panel Discusses Hospital-Based Addiction Medicine
During the recent ASAM Virtual 2020 workshop entitled “Hospital Based Addiction Medicine Cases & Challenges,” a panel of women leaders in addiction medicine discussed treatment approaches to challenging addiction medicine cases in the hospital setting.
Presenters discussed four challenges from two inpatient cases and offered evidence-based treatment approaches, including ways to integrate a diverse addiction medicine workforce into routine hospital-based care.
“A group of us who all either run or have a significant role within addiction medicine consult services in hospitals came together to organize this workshop,” said Melissa Weimer, DO, MCR, FASAM, assistant professor of medicine at Yale University School of Medicine and medical director of the Yale Addiction Medicine Consult Service. “We will describe common challenges in cases we see of patients in the hospital who have substance use disorder.”
The first case highlighted a patient with substance use disorder who may have been using a substance while in the hospital. The case also led to a panel discussion on how to best manage pain associated with surgery. This led to a discussion about continuing buprenorphine in the perioperative setting.
The second case involved a patient who needed to be in the hospital for a prolonged period due significant infectious complications associated with their substance use. The discussion centered on how to best organize care and long-term antibiotics for such patients and reviewed the process of low dose buprenorphine initiation.
Both cases and panel discussions included audience response questions and ample time for questions from the audience.
“We decided to limit the number of cases so we’re able to speak more about these specific needs of the patients we’re presenting,” Dr. Weimer added. “We also wanted to provide a broad set of opinions. Those of us who are presenting come from across the nation so we can speak with regional differences in addiction treatment.”
Other presenters included Susan Calcaterra, MD, MPH, assistant professor at the University of Colorado; Megan Buresh, assistant professor at John’s Hospital; Jeanette Tetrault, MD, associate professor of medicine at Yale; Sarah Wakeman, MD, medical director at the Substance Use Disorder Initiative at Massachusetts General Hospital; and Hannah Snyder, MD, assistant clinical professor at the University of California, San Francisco.
“The integration of addiction medicine specialists within the hospital system is new within the last decade,” Dr. Weimer said. “We’re really hoping to inform everyone of this new practice, how we can best integrate into hospital systems and how we can best work in multidisciplinary teams. Then, hopefully, ASAM members will consider taking that information back to your own health systems to think about how they might consider helping patients in the hospital.”