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American Society of Addiciton Medicine

Home Quality Care Implementation Guidance Implementation Guide for Hospital and Emergency Department SUD Care

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Hospital and Emergency Department Substance Use Disorder Care

https://downloads.asam.org/sitefinity-production-blobs/docs/default-source/guidelines/hospital-implementation/hospital-implementation-guide_final.pdf?sfvrsn=e9a4bbf0_1

Implementation Guidance

Hospital and Emergency Department Substance Use Disorder Care

Implementation Guide

Implementation Guide

Implementation Guide for Hospital and Emergency Department Substance Use Disorder Care

 

Background

SUD is common among patients in hospitals and EDs but often goes unaddressed despite the availability of effective treatments. Untreated SUD is associated with high costs and increased rates of premature hospital discharge and mortality. As universal points of health care access, hospitals and EDs have a unique opportunity to engage people with SUD and reduce related morbidity and mortality. 

The American Society for Addiction Medicine (ASAM) outlines standard capabilities that all hospitals should meet to effectively care for patients with SUD in the Fourth Edition of The ASAM Criteria, released in 2023. These standards offer once framework for the elements of for the elements of care that all hospitalized patients with SUD should receive.

ASAM recognizes that implementing these standards can be challenging for hospitals that are already struggling to meet existing requirements with an overburdened workforce. As such, ASAM convened a Presidential Task Force to develop guidance to support hospitals and EDs to implement these standards.

 

Purpose

Research has demonstrated that touchpoints with EDs and hospitals settings may offer ‘reachable moments’ to initiate effective SUD treatment and transform health systems to better meet the needs of people with SUD. Hospital- or ED-based provision of SUD services, including pharmacotherapy, psychosocial services, linkage to ongoing SUD treatment, and services to reduce the risk of overdose and infectious diseases, has been demonstrated to increase engagement in post-discharge care, reduce hospital readmission, and improve substance use clinical outcomes. ASAM has previously developed standards for general hospitals in The ASAM Criteria, yet more details about how EDs and hospitals can meet these standards are needed. 

The purpose of this document is to:

  • Delineate the services and competencies needed to meet The ASAM Criteria standard for general hospitals
  • Describe care delivery models such as addiction consult services (ACS) and Bridge Clinics which can increase adoption of these care standards
  • Provide guidance to hospital administrators and clinician leaders on how to effectively implement baseline standards of care for patients with SUD in hospital and emergency department settings

 

 

Presidential Task Force 

Sarah Wakeman, MD, FASAM (Chair)
Chethan Bachireddy, MD, MSc, FACP, FASAM
Arianna Campbell, PA-C, MPH
Itai Danovitch, MD, MBA, DFAPA, DFASAM
Honora Englander, MD
Drew Fuller, MD, MPH, FACEP, FASAM
Andrew Herring, MD
Maureen McCollough, MD, MPH

 

 

ASAM Executive Council

Itai Danovitch, MD, MBA, DFAPA, DFASAM (Chair)
Michael P. Frost, MD, DFASAM, FACP 
R. Jeffrey Goldsmith, MD, DLFAPA, DFASAM 
Navdeep Kang, PsyD 
Tiffany Y. Lu, MD, MS 
Tami Mark, PhD, MBA 
Stephen Martin, MD, FASAM
Cynthia Vuittonet, MD, FACP, FASAM
Melissa B. Weimer, DO, MCR, FASAM 

 

 

Field Reviewers

Erin W. Barnes, MD
Christopher Blazes, MD
Susan Calcaterra, MD, MPH/MSPH, MS
James S. Chan, MD, PhD, FACEP
Manuel Celedon, MD
Jose Partida Corona, MD, FASAM
Huiqiong Deng, MD, PhD
Evan Gale, MD
Jason Kirby, DO, MBA, DFASAM
Nathaniel Kratz, MD
Colleen Lane, MD
Samuela Manages, MD, FAAFP, DABFM
Jeanmarie Perrone, MD
Kelly S. Ramsey, MD, MPH, MA, FACP, DFASAM
Kristine Torres-Lockhart, MD, FASAM
Melinda Turner, MD
Nina Vadiei, PharmD, BCPP
Melissa Villars, MD
Scott Weiner, MD, MPH
Michael P. Wilson, MD, PhD, FAAEM, FACEP

 

Staff and Author Contribution

Literature Search and Evidence Summary:  Maureen Boyle, PhD, Dawn Lindsay, PhD and Janette Norrington, PhD
First Draft: Task Force
Revisions: Task Force, Maureen Boyle, PhD, and Sacha K. Song, MD
Final Approval: Board of Directors

 

 

 

Supplemental Materials

A description of the methodology and disclosures of interest is available for download.