Supporting Patients and Care Teams in Responding to and Reducing In-Hospital Substance Use-Slides

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This presentation by Dr. Marlene Martín and Dr. Anna-Maria South addresses the challenge of in-hospital substance use (IHSU), focusing on patient-centered, non-punitive, and harm reduction approaches. Hospitals frequently encounter IHSU, often driven by undertreated pain or withdrawal, boredom, coping needs, stigma, and triggers. Patients with substance use disorders (SUD) are at increased risk for worse outcomes, including self-discharge, higher readmission, and morbidity.<br /><br />The presenters highlight that punitive responses—such as involving law enforcement, searching patients, or discharging them—are common but counterproductive. Instead, best practices emphasize building therapeutic relationships, appropriately managing withdrawal and pain (including offering evidence-based treatments like buprenorphine or methadone), reducing stigma, and using multidisciplinary team approaches. Hospital policies to standardize responses can support equity, create transparency, and guide staff and patients through clear expectations and communication strategies.<br /><br />Case studies illustrate practical responses: for example, treating opioid withdrawal rather than discharging a patient found using opioids; and responding to in-hospital drug use with open-ended dialogue, addiction treatment offerings, and multidisciplinary collaboration rather than punitive measures. Exposure risks to smoked substances such as fentanyl or methamphetamine are minimal with proper precautions.<br /><br />Harm reduction strategies are integral and include overdose education, safer use practices, providing naloxone and supplies, and offering services to reduce boredom and distress during hospitalization. Successful policies develop with staff education, ongoing evaluation, and focus on long-term relationship building.<br /><br />In summary, the session advocates for compassionate, evidence-based care for hospitalized patients with SUD, emphasizing harm reduction, team-based management, and institutional policy development to improve outcomes and reduce in-hospital substance use harms.

Keywords

in-hospital substance use

patient-centered care

harm reduction

substance use disorders

non-punitive approaches

withdrawal management

buprenorphine

methadone

multidisciplinary team

hospital policy