• Drug Alcohol Depend · Jun 2020

    Change in opioid policies in New England emergency departments, 2014 vs 2018.

    • Maranatha M Teferi, Krislyn M Boggs, Janice A Espinola, Ramsey Herrington, Nathan W Mick, Maia S Rutman, Arjun K Venkatesh, Christopher P Zabbo, Kohei Hasegawa, Margaret E Samuels-Kalow, Scott G Weiner, and Carlos A Camargo.
    • Department of Emergency Medicine, Massachusetts General Hospital, 125 Nashua St., Suite 920, Boston, MA 02114, United States. Electronic address: mteferi@mgh.harvard.edu.
    • Drug Alcohol Depend. 2020 Jun 10; 213: 108105.

    ObjectiveThe U.S. opioid epidemic persists, yet it is unclear if opioid-related emergency department (ED) policies have changed. We investigated: 1) the prevalence of opioid use disorder (OUD) prevention and treatment policies in New England EDs in 2018, and 2) how these policies have changed since 2014.MethodsUsing the National Emergency Department Inventory-USA, we identified and surveyed all New England EDs in 2015 and 2019 about opioid-related policies in 2014 and 2018, respectively. The surveys assessed OUD prevention policies (to use a screening tool, access the Prescription Drug Monitoring Program [PDMP], notify primary care providers, prescribe/dispense naloxone) and treatment policies (to refer to recovery resources, prescribe/dispense buprenorphine).ResultsOf 194 EDs open in 2018, 167 (86 %) completed the survey. Of 193 EDs open in 2018 and 2014, 147 (76 %) completed both surveys. In 2018, the most commonly-reported policy was accessing the PDMP (96 %); the least commonly-reported policy was prescribing/dispensing buprenorphine to at risk patients (37 %). EDs varied in prescribing/dispensing naloxone: 35 % of EDs offered naloxone to ≥80 % of patients at risk of opioid overdose versus 33 % of EDs to <10 % of patients at risk. Most EDs (74 %) reported prescribing/dispensing buprenorphine to <10 % of patients with OUD. Comparing 2018 to 2014, the greatest difference in policy use was in prescribing/dispensing naloxone (+55 %, p < 0.001).ConclusionImplementation of opioid-related ED policies increased between 2014 and 2018. Continued effort is needed to understand the extent to which policy implementation translates to clinical care, and to best translate evidence-based policies into clinical practice.Copyright © 2020 Elsevier B.V. All rights reserved.

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