ED-based Counseling Sessions Reduce Risky Opioid Use Among Certain Patients
Investigators at the University of Michigan have shown promising results from an ED-based intervention designed to curb risky opioid use among patients who have reported opioid misuse within the previous three months. The intervention includes a 30-minute counseling session with a therapist who utilizes motivational interviewing techniques to strengthen their desire to move away from opioid use behaviors.
- The randomized clinical trial included 204 emergency patients, divided between patients receiving printed educational materials and patients receiving printed materials as well as counseling sessions.
- Researchers followed up with all patients after six months, finding that those who received the counseling intervention demonstrated a substantially higher reduction in behaviors that heighten the risk of an overdose than patients who received only printed materials.
- Investigators are working now to adapt the counseling intervention so that it can be delivered by more cost-efficient means, such as via interactive voice response messages or computer.
Opioid-related Hospitalizations, Infections Up
The opioid crisis sweeping the country is putting considerable pressure on healthcare utilization and costs, according to new research from Beth Israel Deaconess Medical Center and the VA Boston Healthcare System. Analyzing discharge data from a nationally representative sample of inpatient hospitalizations, investigators found that while the number of hospitalizations overall remained consistent between 2002 and 2012, hospitalizations related to opioid use or dependence increased by 72% to 520,275 during this period. Within this group, hospitalizations related specifically to a serious infection increased by 91% to 6,535.1
With regard to costs, total inpatient charges related to opioid abuse or dependence quadrupled during the decade to $15 billion in 2012. From this sum, researchers noted that $700 million went toward hospitalizations related to opioid-associated infections. The total average cost of an opioid-related hospitalization was more than $28,000 in 2012; however, the average cost for hospitalizations that involved opioid-related infections topped $107,000.
Investigators said the burden of these costs was particularly costly for Medicaid, which was the most common payer for opioid-related hospitalizations. Just 20% of the discharges related to opioid use or dependence and 14% of discharges associated with an opioid-related infection were covered by private payers.
To ease such burdens, researchers recommended a commitment to curbing access to opioids as well as a stronger focus on early treatment and preventive strategies.
- Ronan M, Herzig S. Hospitalizations related to opioid abuse/dependence and associated serious infections increased sharply, 2002-12. Health Aff 2016;35:832-837.
Investigators say focusing on harm reduction rather than ending use of all opiate medications represents a major shift in thinking, making participants more receptive to the intervention.
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