Landing in a hospital is a moment that most people hope to avoid, but for individuals battling opioid use disorder (OUD), hospitalization often signals a particularly troubling point in their health journey. Opioid use disorder continues to be a major public health crisis, with devastating consequences for individuals, families, and communities. However, a new wave of research is offering a hopeful perspective on how hospitals can play a more proactive role in managing OUD. Recent findings show that in-hospital opioid use disorder treatment can significantly improve long-term recovery outcomes.
The research, conducted by a team from the New York University Grossman School of Medicine in collaboration with New York City Health + Hospitals, focuses on the effectiveness of an innovative program known as the Consult for Addiction Treatment and Care in Hospitals (CATCH). This program, which integrates addiction treatment services directly into the hospital setting, has demonstrated substantial clinical benefits for individuals with opioid use disorder, including significantly higher rates of medication initiation and retention after discharge.
The Study: CATCHing the Opportunity for Change
The study aimed to assess the impact of the CATCH program in six hospitals, tracking how in-hospital addiction consult teams could facilitate the initiation and continuation of medication for opioid use disorder (MOUD) among hospitalized patients. The results have far-reaching implications for both medical practice and public health.
At its core, the findings of the study revealed that individuals hospitalized with OUD who had access to in-hospital opioid use disorder treatment through the CATCH program were about eight times more likely to begin MOUD and seven times more likely to continue treatment 30 days after discharge. This is a remarkable improvement over the outcomes for patients who did not receive this specialized intervention.
The study tracked a cohort of 2,315 patients from October 2017 to January 2021, providing valuable insight into the impact of CATCH on patient outcomes. These patients either received care from interdisciplinary CATCH teams or received standard hospital care without the support of the program. The CATCH teams included three key members: an addiction physician or nurse practitioner (who led the team), a social worker or addiction counselor, and a peer counselor. Together, they worked to provide holistic care for each patient, integrating medical treatment with emotional and social support, which is often crucial for long-term recovery.
How the CATCH Program Works
The CATCH program aims to address the significant gap in care for individuals with OUD. Traditionally, patients hospitalized with substance use disorders often face significant barriers to continuing treatment after discharge, leading to relapse and, in many cases, overdose. However, CATCH teams are designed to intervene in a targeted way during hospitalization to ensure that patients have the best possible chance of engaging with treatment.
One of the critical elements of the CATCH program is the bedside consultation. CATCH providers are available to make diagnoses, recommend individualized care plans, and offer harm reduction strategies. This approach ensures that patients are not just treated for immediate medical issues but are also given the tools and resources they need to begin their recovery journey during their hospital stay.
The services provided by CATCH include:
- Medication for Opioid Use Disorder (MOUD): CATCH teams are trained to prescribe medications like methadone, buprenorphine, or naltrexone, which have been proven to significantly reduce the risk of overdose and improve long-term recovery outcomes.
- Harm Reduction Strategies: This includes providing patients with take-home naloxone, a medication that can reverse opioid overdoses, as well as addressing other immediate needs like mental health support.
- Peer Support: A crucial aspect of the CATCH program is involving peer counselors—individuals who have personal experience with addiction and recovery. Peer counselors can provide invaluable emotional support, help reduce stigma, and offer a sense of hope and relatability for patients facing a difficult recovery path.
- Linking to Community-Based Treatment: A key component of the program is ensuring that patients are connected to ongoing addiction treatment resources once they leave the hospital. If immediate treatment connections cannot be made, patients are referred to short-term bridge clinics staffed by CATCH providers, which can help smooth the transition from hospital to community-based care.
By providing in-hospital opioid use disorder treatment, CATCH ensures that patients are not leaving the hospital without a clear path to continued care, which is often a critical barrier to recovery.
The Impact: Positive but Room for Improvement
While the study’s results show significant improvements in treatment initiation and retention, they also highlight some of the challenges that remain. Specifically, the rates of MOUD initiation were higher for those who received CATCH services—11% compared to just 7% for those who did not. Similarly, 3% of patients who received CATCH care continued with their MOUD treatment after six months, compared to just 2% in the control group. These numbers, while encouraging, underscore the fact that more needs to be done to address the systemic and individual barriers to long-term treatment retention.
The study also pointed out that absolute rates of treatment initiation and retention remained relatively low overall, signaling that while hospital-based interventions like in-hospital opioid use disorder treatment are a significant improvement, they are not enough on their own to fully address the complexities of opioid use disorder. Factors such as stigma, lack of access to long-term care, and limited community resources continue to make it difficult for patients to maintain consistent treatment after they leave the hospital.
A Call for Systemic Change
Dr. Jennifer McNeely, the principal investigator of the study and an associate professor at NYU Langone, discussed the broader implications of these findings in a recent news release. Dr. McNeely emphasized that addiction consult programs like CATCH have the potential to significantly reduce the negative consequences of untreated substance use disorders. She noted:
“We have highly effective medications for treating opioid use disorder and preventing overdose, but far too few patients are receiving them. Addiction consult programs like CATCH have tremendous potential to reduce the negative consequences of untreated substance use disorder.”
Dr. McNeely’s words reflect a critical issue in addiction treatment: despite the availability of effective medications and treatments, there remains a disparity in access to these resources, especially in marginalized populations. Programs like CATCH provide hope that a more coordinated, compassionate, and comprehensive approach to addiction treatment can be implemented within hospital systems to change these outcomes.
Looking Ahead: The Future of Addiction Treatment in Hospitals
One of the most promising aspects of the CATCH program is that it can be replicated and scaled across hospitals nationwide. Dr. McNeely hopes that programs like CATCH will be replicated, reimbursed, and integrated into hospitals across the country to transform how patients with substance use disorders are treated.
The CATCH model demonstrates that hospitals can play a crucial role in addressing addiction—not just through emergency care but as a critical point of intervention for long-term recovery. The key to success lies in integrating addiction treatment into the broader healthcare framework, ensuring that patients not only receive medical care for immediate issues but also gain access to ongoing addiction treatment services.
By supporting in-hospital opioid use disorder treatment, hospitals can offer a critical support system for patients, helping them start their recovery journey and continue care beyond discharge. The future of addiction treatment may well depend on these kinds of hospital-based interventions that can reach people in their most vulnerable moments and offer them a lifeline.
Conclusion: Transforming Addiction Treatment One Hospital at a Time
The CATCH program offers a promising model for addressing opioid use disorder in a hospital setting. By focusing on early intervention, comprehensive care, and community-based follow-up, it provides patients with the tools they need to recover and thrive. While there are still challenges to overcome—particularly in terms of long-term engagement with treatment—the study’s findings suggest that integrating addiction treatment into hospital care is a step in the right direction.
As the opioid crisis continues to affect millions of people, initiatives like CATCH have the potential to save lives, reduce overdoses, and ultimately change the trajectory of the opioid epidemic. With continued investment in programs like this, hospitals across the U.S. could become powerful allies in the fight against opioid use disorder, ensuring that every patient has access to the care they need to recover and rebuild their lives.
As Dr. McNeely concludes:
“It is our hope that programs like CATCH will be replicated, reimbursed, and rolled out at hospitals across the country, to transform hospital care for patients with substance use disorder.”
The future of addiction treatment is bright—if we continue to innovate, collaborate, and ensure that every individual has access to the help they need at the critical moment of hospitalization.
