A new nationwide study shows that a scant proportion of hospitalised patients with opioid use disorder receive proven life-saving medications both during and after they are discharged.

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This is despite the national opioid-related overdose epidemic that continues to claim tens of thousands of lives annually. The study was published in the Journal of General Internal Medicine. "It really paints a bleak picture of the current state of affairs about the treatment of people with opioid use disorder nationwide," said lead author Kelsey Priest, Ph.D., M.P.H., a health systems researcher and current M.D./Ph.D. student in the Oregon Health and Science University School of Medicine.

The study plumbed an extensive database of patients in the Department of Veterans Affairs healthcare system. Researchers identified more than 12,000 patients across 109 hospitals who were hospitalised for various reasons but also had underlying opioid use disorder during the fiscal year ending in 2017. The researchers identified 10,969 patients who had opioid use disorder at the time they were hospitalised but were not receiving treatment.

Out of those patients, only 203 -- 2 per cent -- received a medication to treat opioid use disorder while they were in the hospital and were subsequently linked to care after their discharge. This is important because findings from an earlier study from OHSU showed that patients who received medication such as buprenorphine in the hospital are twice as likely to continue their therapy after discharge. "This is a huge missed opportunity," said co-author Honora Englander, M.D., associate professor of medicine in the OHSU School of Medicine. Englander is director of an in-hospital intervention program that OHSU started in 2015.

Project IMPACT, or Improving Addiction Care Team, brings together physicians, social workers, peer-recovery mentors and community addiction providers to address addiction when patients are admitted to the hospital. The programme is a rare exception, although part of a small but growing cohort of hospitals nationwide implementing these services. The need for these interventions is clear based on the study published. "Hospitalisation is a reachable moment to initiate and coordinate therapy to treat substance use disorder. This study shows that in the VA - which most likely out-performs other US hospitals -- life-saving, evidence-based treatment is rarely prescribed," Englander said.

Opioid agonist therapies available in the hospital include methadone or buprenorphine. Both relieve withdrawal symptoms and pain, normalising brain function by acting on the same targets in the brain as prescription opioids or heroin.