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Health Care Policy and Law
November 18, 2019

Facilitating Methadone Use in Hospitals and Skilled Nursing Facilities

Author Affiliations
  • 1Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 2Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
  • 3Institutes for Behavior Resources Inc, REACH Health Services, Baltimore, Maryland
JAMA Intern Med. 2020;180(1):7-8. doi:10.1001/jamainternmed.2019.5731

People with opioid use disorder (OUD) frequently require prolonged hospital and skilled nursing facility care for complications of their drug use—including wounds, endocarditis, hepatitis, HIV/AIDS, and acute exacerbations of chronic diseases. In 2012, there were 500 000 hospitalizations related to OUD in the United States; in about 1 in 10 of these admissions, the patient was discharged to a skilled nursing facility.1 Current federal regulations, however, complicate the provision of effective treatment for OUD in hospitals and skilled nursing facilities. As a result, many patients experience costly cycles of complications, admission, discharge, repeated complications, and readmission with little gain to their health. In this Viewpoint, we argue that changing regulations of the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Drug Enforcement Administration (DEA) to align with evidence could expand access to care and save lives.

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