Tags

Type your tag names separated by a space and hit enter

Leadership Roles in Opioid Stewardship and the Treatment of Patients with Opioid Use Disorder Among Medical Toxicologists.
J Med Toxicol. 2020 04; 16(2):204-211.JM

Abstract

BACKGROUND

Despite significant efforts, deaths due to drug overdose remain at near record levels. In efforts combat this crisis, the Joint Commission now requires that accredited hospitals implement safe opioid prescribing practices. Emergency department visits and hospitalizations related to opioid use disorder (OUD) provide an opportunity to initiate evidence-based treatment. However, both situations require the presence of qualified physician leaders and clinicians, which many facilities lack. Medical toxicologists have the expertise needed to fill these voids, but the scope and prevalence of their involvement are unknown. We sought to determine the engagement of medical toxicologists in leading opioid stewardship initiatives and the treatment of patients with OUD.

METHODS

Members of the American College of Medical Toxicology (ACMT) were surveyed about their leadership roles in opioid stewardship and clinical practices regarding OUD from March-June 2019. ACMT represents more than 80% of the nation's board-certified medical toxicologists. The electronic survey utilized branching logic and results are presented descriptively; thus, responses are presented as a percentage of the number of respondents to individual questions rather than the total number of participants.

RESULTS

One hundred and thirty-one out of 382 eligible individuals from at least 76 institutions responded to the survey. A majority (60%) had a DATA 2000 X-waiver, 21% were board-certified in addiction medicine (AM), and an additional 22% were definitely or possibly planning to pursue board certification in AM. Sixteen percent of respondents reported having a formal leadership role to address opioid pain management and stewardship, and 17% had a formal leadership role that specifically addresses clinical treatment for OUD within their institution. Fifty-seven respondents prescribed buprenorphine in emergency medicine practice, 41 as inpatient consultants, and 23 in an outpatient clinic.

CONCLUSIONS

Medical toxicologists can serve as leaders to promote safe opioid prescribing practices through both institutional and governmental opioid task forces and opioid stewardship programs. They also provide important addiction-related clinical care to patients with OUD.

Authors+Show Affiliations

Emory University School of Medicine, 50 Hurt Plaza SE, Suite 600, Atlanta, GA, 30303, USA. jecarpe@emory.edu.Emory University School of Medicine, 50 Hurt Plaza SE, Suite 600, Atlanta, GA, 30303, USA. Wright-Patterson Medical Center, Wright-Patterson AFB, OH, USA.MedStar Washington Hospital Center, Washington, D.C, USA.Hennepin Healthcare, Minneapolis, MN, USA.University of Rochester Medical Center, Rochester, NY, USA.Rutgers New Jersey Medical School, Newark, NJ, USA.University of Pennsylvania, Philadelphia, PA, USA.Washington University School of Medicine in St. Louis, St. Louis, MO, USA.University of Rochester Medical Center, Rochester, NY, USA.University of Texas Southwestern Medical School, Dallas, TX, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31863312

Citation

Carpenter, Joseph E., et al. "Leadership Roles in Opioid Stewardship and the Treatment of Patients With Opioid Use Disorder Among Medical Toxicologists." Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology, vol. 16, no. 2, 2020, pp. 204-211.
Carpenter JE, Murray BP, Mazer-Amirshahi M, et al. Leadership Roles in Opioid Stewardship and the Treatment of Patients with Opioid Use Disorder Among Medical Toxicologists. J Med Toxicol. 2020;16(2):204-211.
Carpenter, J. E., Murray, B. P., Mazer-Amirshahi, M., Laes, J. R., Nacca, N., Nelson, L. S., Perrone, J., Schwarz, E. S., Wiegand, T. J., & Wax, P. M. (2020). Leadership Roles in Opioid Stewardship and the Treatment of Patients with Opioid Use Disorder Among Medical Toxicologists. Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology, 16(2), 204-211. https://doi.org/10.1007/s13181-019-00752-9
Carpenter JE, et al. Leadership Roles in Opioid Stewardship and the Treatment of Patients With Opioid Use Disorder Among Medical Toxicologists. J Med Toxicol. 2020;16(2):204-211. PubMed PMID: 31863312.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Leadership Roles in Opioid Stewardship and the Treatment of Patients with Opioid Use Disorder Among Medical Toxicologists. AU - Carpenter,Joseph E, AU - Murray,Brian Patrick, AU - Mazer-Amirshahi,Maryann, AU - Laes,JoAn R, AU - Nacca,Nicholas, AU - Nelson,Lewis S, AU - Perrone,Jeanmarie, AU - Schwarz,Evan S, AU - Wiegand,Timothy J, AU - Wax,Paul M, Y1 - 2019/12/20/ PY - 2019/09/25/received PY - 2019/11/19/accepted PY - 2019/11/13/revised PY - 2019/12/22/pubmed PY - 2021/6/1/medline PY - 2019/12/22/entrez KW - Addiction medicine KW - Buprenorphine KW - Opioid use disorder KW - Toxicology SP - 204 EP - 211 JF - Journal of medical toxicology : official journal of the American College of Medical Toxicology JO - J Med Toxicol VL - 16 IS - 2 N2 - BACKGROUND: Despite significant efforts, deaths due to drug overdose remain at near record levels. In efforts combat this crisis, the Joint Commission now requires that accredited hospitals implement safe opioid prescribing practices. Emergency department visits and hospitalizations related to opioid use disorder (OUD) provide an opportunity to initiate evidence-based treatment. However, both situations require the presence of qualified physician leaders and clinicians, which many facilities lack. Medical toxicologists have the expertise needed to fill these voids, but the scope and prevalence of their involvement are unknown. We sought to determine the engagement of medical toxicologists in leading opioid stewardship initiatives and the treatment of patients with OUD. METHODS: Members of the American College of Medical Toxicology (ACMT) were surveyed about their leadership roles in opioid stewardship and clinical practices regarding OUD from March-June 2019. ACMT represents more than 80% of the nation's board-certified medical toxicologists. The electronic survey utilized branching logic and results are presented descriptively; thus, responses are presented as a percentage of the number of respondents to individual questions rather than the total number of participants. RESULTS: One hundred and thirty-one out of 382 eligible individuals from at least 76 institutions responded to the survey. A majority (60%) had a DATA 2000 X-waiver, 21% were board-certified in addiction medicine (AM), and an additional 22% were definitely or possibly planning to pursue board certification in AM. Sixteen percent of respondents reported having a formal leadership role to address opioid pain management and stewardship, and 17% had a formal leadership role that specifically addresses clinical treatment for OUD within their institution. Fifty-seven respondents prescribed buprenorphine in emergency medicine practice, 41 as inpatient consultants, and 23 in an outpatient clinic. CONCLUSIONS: Medical toxicologists can serve as leaders to promote safe opioid prescribing practices through both institutional and governmental opioid task forces and opioid stewardship programs. They also provide important addiction-related clinical care to patients with OUD. SN - 1937-6995 UR - https://neuro.unboundmedicine.com/medline/citation/31863312/Leadership_Roles_in_Opioid_Stewardship_and_the_Treatment_of_Patients_with_Opioid_Use_Disorder_Among_Medical_Toxicologists_ L2 - https://dx.doi.org/10.1007/s13181-019-00752-9 DB - PRIME DP - Unbound Medicine ER -