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Inpatient opioid withdrawal: a qualitative study of the patient perspective

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Abstract

Opioid withdrawal is common among hospitalized patients. Those with substance use disorders exhibit higher rates of patient-directed discharge. The literature lacks information regarding the patient perspective on opioid withdrawal in the hospital setting. In this study, we aimed to capture the patient-reported experience of opioid withdrawal during hospitalization and its impact on the desire to continue treatment for opioid use disorder after discharge. We performed a single-center qualitative study involving semi-structured interviews of hospitalized patients with opioid use disorder (OUD) experiencing opioid withdrawal. Investigators conducted in-person interviews utilizing a combination of open-ended and dichotomous questions. Interview transcripts were then analyzed with open coding for emergent themes. Nineteen interviews were performed. All participants were linked to either buprenorphine (79%) or methadone (21%) at discharge. Eight of nineteen patients (42%) reported a patient-directed discharge during prior hospitalizations. Themes identified from the interviews included: (1) opioid withdrawal was well-managed in the hospital; (2) patients appreciated receiving medication for opioid use disorder (MOUD) for withdrawal symptoms; (3) patients valued and felt cared for by healthcare providers; and (4) most patients had plans to follow-up for opioid use disorder treatment after hospitalization. In this population with historically high rates of patient-directed discharge, patients reported having a positive experience with opioid withdrawal management during hospitalization. Amongst our hospitalized patients, we observed several different individualized MOUD induction strategies. All participants were offered MOUD at discharge and most planned to follow-up for further treatment.

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Funding

1. Mancini Grant, Salt Lake City, Utah 2. Utah Quality Advancement Laboratory (UQuAL), University of Utah, Salt Lake City, Utah.

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Authors and Affiliations

  1. Division of General Internal Medicine, Department of Internal Medicine, University of Utah School of Medicine, 30 N. Mario Capecchi Drive, 3rd Floor South, Salt Lake City, UT, 84112, USA

    Danielle M. Babbel, David R. Chen, Valerie M. Vaughn & Stacy A. Johnson

  2. Division of General Internal Medicine and Geriatrics, Department of Medicine, Section of Addiction Medicine, Oregon Health and Science University, Portland, OR, USA

    Patricia Liu

  3. Division of Health System Innovation and Research, Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA

    Valerie M. Vaughn

  4. Informatics, Decision-Enhancement and Analytic Sciences Center, VA Salt Lake City Healthcare System, University of Utah, Salt Lake City, UT, USA

    Susan Zickmund

  5. Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA

    Susan Zickmund, Kennedi Bloomquist & Tobias Zickmund

  6. Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA

    Elizabeth F. Howell

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  1. Danielle M. Babbel
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Correspondence to Danielle M. Babbel.

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Babbel, D.M., Liu, P., Chen, D.R. et al. Inpatient opioid withdrawal: a qualitative study of the patient perspective. Intern Emerg Med (2024). https://doi.org/10.1007/s11739-024-03604-9

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