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Tools to Support Hospital-Based Addiction Care

Core Components, Values, and Activities of the Improving Addiction Care Team

Englander, Honora, MD; Mahoney, Stacey, LCSW, CADC; Brandt, Kimberly, FNP-BC; Brown, Jessica, LCSW; Dorfman, Claire, BA; Nydahl, Alexander, PA; Weimer, Melissa, DO; Gregg, Jessica, MD, PhD

doi: 10.1097/ADM.0000000000000487

Hospitals are increasingly filled with people admitted for medical and surgical complications of substance use disorder (SUD). Hospitalization can be a reachable moment to engage and initiate SUD care. Yet most hospitals do not have systems in place to adequately address addiction, and most providers have little to no addiction training. There is widespread need for protocols and tools to implement hospital-based SUD care. We share best practices from our hospital-based Improving Addiction Care Team (IMPACT). We include a description of interprofessional roles (medical providers, social workers, peers with lived experience in recovery) and include detailed appendices of practical tools such as medication protocols (eg, buprenorphine induction), risk assessments (eg, outpatient parenteral antibiotic therapy) and treatment tools (eg, a patient safety care plan to manage patient and staff expectations surrounding risks for in hospital drug use). A case example illustrates how IMPACT works and how tools can be applied. We hope other hospitals can adapt and integrate these tools to support widespread implementation of hospital-based SUD care.

Oregon Health & Science University, Portland, OR.

Send correspondence to Honora Englander, MD, Division of Hospital Medicine, BTE 119, Oregon Health & Science University, 3181 SW Sam Jackson Road, Portland, OR 97239. E-mail:

Received 5 September, 2018

Accepted 11 November, 2018

This work was funded and supported by Oregon Health & Science University.

The authors report no conflicts of interest to disclose.

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© 2019 American Society of Addiction Medicine