Considerations for Safely Discharging Patients from MOUD Programs
Research has shown that mortality rates increase
following discharge from opioid use disorder (OUD) treatment. To improve medication adherence,
providers should recognize that patients may leave treatment for a variety of reasons including lack
of transportation, conflicting work schedules, high cost of services, and relapse. Therefore, a
program providing medication for opioid use disorder (MOUD) should consider ways to offer flexible
long-term recovery options and connect patients to follow-up services. For example, one MOUD
program in rural Utah offers patients access to case management services for at least six months
after graduating from the program.
Recovery from OUD is often cyclical, rather than linear. Policies and practices that leave the door
open, rather than discharge patients when they relapse, allow patients to return to treatment
whenever they would like. Providers can, for example, work with the patient to revise their treatment
If it is known in advance that a patient will be discharged from MOUD treatment, individualized,
post-treatment planning can be crucial for ensuring ongoing recovery support. This could include
offering aftercare services until the patient is connected with a new provider, linking the patient
with community resources like vocational support, coordinating care across settings, and facilitating
transitions with a warm hand-off. Aftercare services support recovery maintenance and can be as
simple as phone-based check-ins.
Engaging the patient's support system, including family and friends, is also important in supporting
long-term recovery, especially as medical supports and treatment teams may be shifting. Bridge
clinics and other innovative
technologies may be available to support individuals on a waitlist for MOUD programs or patients
transitioning from inpatient or residential treatment to the primary care setting.
Patients may feel increasingly anxious as they approach discharge from treatment. MOUD providers may
also face challenges anticipating future patient needs and potentially limited availability of
community resources in their rural community. When implementing an MOUD program, organizations can
mitigate some of these challenges by being proactive in the post-treatment planning process, defining
discharge policies, writing down post-treatment planning protocols, standardizing planning forms,
training staff involved in the process, fostering relationships with community organizations, and
tracking patient follow-up data.
Resources to Learn More
Caring for Patients with Opioid Use Disorder in
Discusses the underuse of addiction-specific interventions for adult patients with opioid use
disorder (OUD) during acute hospital admissions and at time of discharge. Covers current guidelines
and studies on the use of opioid therapy, management of opioid withdrawal and overdose, and treatment
for acute pain. Includes a checklist with factors to consider before hospital discharge.
Author(s): Donroe, J.H., Holt, S.R., & Tetrault, J.M.
Citation: Canadian Medical Association Journal, 188(17-18), 1232-1239
Treatment (MAT) in SUD Residential Toolkit
Provides information and resources for residential treatment programs developing practices and
policies for MAT and MOUD services. Includes specific guidelines for establishing client discharge
Organization: Alaska Department of Health and Social Services Division of Behavioral