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Rural Health Information Hub

Inpatient Initiation Model

In the inpatient initiation model, a patient is identified and begins medication for opioid use disorder (MOUD) during a hospital stay. Following discharge, the patient continues MOUD outside of the hospital, such as in a primary care setting through office-based opioid treatment (OBOT). Some patients may need a “bridge” clinic to help stabilize treatment before moving to primary care or another treatment setting.

Inpatient initiation of MOUD is important because it may help identify patients experiencing complex health issues, such as co-occurring behavioral health conditions, cognitive impairments, and other substance use, for whom substance use disorder may be overlooked by other providers.

Implementation Considerations

Rural programs will need to work closely with hospitals to garner support for inpatient initiation of MOUD. In particular, hospitals may need to develop internal processes and designate staff to screen patients. Following initiation of treatment and referral to external treatment settings, it can help to share information and data on patients that have continued treatment following discharge from the hospital.

Resources to Learn More

Inpatient Buprenorphine Induction for Opioid Use Disorder
Describes the buprenorphine team (BT) approach for offering hospitalized patients with opioid use disorder (OUD) the opportunity to begin buprenorphine medication-assisted treatment (MAT) during their stay. Discusses the characteristics hospital staff should look for prior to referring a patient to the BT. Identifies common misconceptions about the MAT program.
Organization(s): University of Texas at Austin
Date: 6/2018