Providers' Experiences and Perspectives in Treating Patients With Co-Occurring Opioid and Stimulant Use Disorders in the Hospital.

Autor:	Shearer RD; Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, USA.; Health, Homelessness, and Criminal Justice Lab, Hennepin Healthcare Research Institute, Minneapolis, MN, USA., Hernandez E; Department of Pharmacology, University of Minnesota Medical School, Minneapolis, MN, USA., Beebe TJ; Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, USA., Virnig BA; College of Public Health and Health Professions, University of Florida, Gainsville, FL, USA., Bart G; Division of Addiction Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis, MN, USA., Winkelman TNA; Health, Homelessness, and Criminal Justice Lab, Hennepin Healthcare Research Institute, Minneapolis, MN, USA.; Division of General Internal Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis, MN, USA., Bazzi AR; Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, CA, USA., Shippee ND; Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, USA.
Jazyk:	angličtina
Zdroj:	Substance use & addiction journal [Subst Use Addctn J] 2024 Apr; Vol. 45 (2), pp. 250-259. Date of Electronic Publication: 2024 Jan 09.
DOI:	10.1177/29767342231221060
Abstrakt:	Background: The overdose crisis is increasingly characterized by opioid and stimulant co-use. Despite effective pharmacologic treatment for both opioid use disorder (OUD) and contingency management for stimulant use disorders, most individuals with these co-occurring conditions are not engaged in treatment. Hospitalization is an important opportunity to engage patients and initiate treatment, however existing hospital addiction care is not tailored for patients with co-use and may not meet the needs of this population. Methods: Semi-structured interviews were conducted with hospital providers about their experiences and perspectives treating patients with opioid and stimulant co-use. We used directed content analysis to identify common experiences and opportunities to improve hospital-based treatment for patients with co-use. Results: From qualitative interviews with 20 providers, we identified 4 themes describing how co-use complicated hospital-based substance use treatment: (1) patients' unstable circumstances impacting the treatment plan, (2) co-occurring withdrawals are difficult to identify and treat, (3) providers holding more stigmatizing views of patients with co-use, and (4) stimulant use is often "ignored" in the treatment plans. Participants also described a range of potential opportunities to improve hospital-based treatment of co-use that fall into 3 categories: (1) provider practice changes, (2) healthcare system changes, and (3) development and validation of clinical tools and treatment approaches. Conclusions: We identified unique challenges providing hospital addiction medicine care to patients who use both opioids and stimulants. These findings inform the development, implementation, and testing of hospital-based interventions for patients with co-use. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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