• Joseph E Carpenter, Jillian Catalanotti, Melissa Notis, Christopher Brokus, Timothy P Moran, Hana Akselrod, Greer Burkholder, Ellen F Eaton, Irene Kuo, William Mai, Keanan McGonigle, Alaina Steck, Carlos Del Rio, Michael Saag, Shyamasundaran Kottilil, Henry Masur, Sarah Kattakuzhy, and Elana S Rosenthal.
• Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
• J Hosp Med. 2023 Aug 1; 18 (8): 670676670-676.

BackgroundStigma surrounding opioid use disorder (OUD) is a barrier to treatment. The use of stigmatizing language may be evidence of negative views toward patients.ObjectiveWe aimed to identify associations between language and clinical outcomes in patients admitted for infectious complications of OUD.DesignsWe performed a retrospective medical record review.Settings And ParticipantsFour U.S. academic health systems. Participants were patients with OUD admitted for infectious complications of injection opioid use from January 1, 2018, to December 31, 2018, identified through international classification of diseases, 10th revision codes consistent with OUD and acute bacterial/fungal infection.Main Outcome And MeasuresDischarge summaries were reviewed for language, specifically: abuse, addiction, dependence, misuse, use disorder, intravenous drug use, and others. Binary outcomes including medication for OUD, planned discharge, naloxone provision, and an OUD treatment plan were evaluated using logistic regressions and admission duration was evaluated using Gamma regression.ResultsA total of 1285 records were reviewed and 328 met inclusion criteria. Of those, 191 (58%) were male, with a median age of 38 years. The most common term was "abuse" (219, 67%), whereas "use disorder" was recorded in 75 (23%) records. Having "use disorder" in the discharge summary was associated with increased odds of having a documented plan for ongoing OUD treatment (adjusted odds ratio [AOR]: 4.11, 95% confidence interval [CI]: 1.89-8.93) and having a documented plan for addiction-specific follow-up care (AOR: 2.31, 95% CI: 1.30-4.09).ConclusionsStigmatizing language was common in this study of patients hospitalized for infectious complications of OUD. Best-practice language was uncommon, but when used was associated with increased odds of addiction treatment and specialty care referrals.© 2023 Society of Hospital Medicine.

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