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Patients With Substance Use Disorders Leaving Against Medical Advice

Strategies for Improvement

Lail, Parabhdeep, MD; Fairbairn, Nadia, MD

doi: 10.1097/ADM.0000000000000432
Editor's Choice

In this issue of the Journal of Addiction Medicine, 2 studies fill an important gap in knowledge by examining predictors of leaving against medical advice from inpatient withdrawal management settings. The studies identify important risk factors for leaving against medical advice and highlight important areas for inpatient withdrawal management. These include the use of substance specific standardized protocols and initiation of opioid agonist treatment instead of opioid detoxification given harms associated with opioid withdrawal. Further need for increased training in addiction medicine for primary care physicians, and use of inpatient addiction medicine consult services as part of early intervention for substance withdrawal are also discussed.

Department of Medicine, University of British Columbia (PL), and British Columbia Centre on Substance Use, Vancouver, BC, Canada (NF).

Send correspondence to Nadia Fairbairn, MD, Assistant Professor, British Columbia Centre on Substance Use, British Columbia Centre for Excellence in HIV/AIDS, University of British Columbia, St Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6. E-mail:

Received 25 May, 2018

Accepted 26 May, 2018

Dr Lail is supported by the US National Institutes of Health (R25DA037756) Canadian Addiction Medicine Research Fellowship. Dr Nadia Fairbairn is supported by a Michael Smith Foundation for Health Research/St. Paul's Foundation Scholar Award. Funding agencies had no role in the research, design, or writing of the manuscript, nor did they have a role in the decision to submit the paper for publication.

The authors declare no conflicts of interest.

© 2018 American Society of Addiction Medicine