Reducing Readmission Rates for Opiate Addicts

Reducing readmission rates of opiate addicts to Yale New Haven Hospital

Currently, prescription pain medication abuse, as well as heroin use, are growing epidemics in the United States. How can we address this epidemic on a local scale, reducing readmission rates of addicts to Yale New Haven Hospital? Roughly 21-29% of patients prescribed opioids for chronic pain misuse them. Between 8-12% develop an opioid use disorder. ~4-6% who misuse prescription opioids transition to heroin. High rate of relapse related to neurobiological changes that accompany addiction. “40 to 60% of patients treated for addiction relapse within a year, and the rate is highest for tobacco addiction”. Onset, severity, and management of condition affected by interactions of biological and behavioral variables analogous to other chronic diseases. An individual’s treatment plan must be assessed continually and modified to ensure the plan meets the changing needs. From these interviews, we learned more about surgeries and drugs, sober houses, transportation to AA, volunteer calls, patient discharge after NARCAN, the problems of stigma and lack of education, and the significance of prior trauma plus mental health issues on opiate abuse. To focus our efforts, we wondered: How Can We increase patient’s utility from the hospital’s program, adapt the treatment to each individual patient, catch risk factors and give support before a relapse/follow-up effectively after patients have been discharged, and identify and target more at-risk groups? We reframed the problems, recognizing that our solution must: streamline volunteer process and boost morale. To reduce the readmission rate of opioid addicts, we aimed to develop preventive solutions. Solution: A wristband, that every patient treated for opioid addiction can take with them when they begin out of hospital treatment. Aim: The wrist band has the phone numbers of local helplines and works as a constant reminder for patients that when they need help, these are resources they can reach out to immediately. Next steps: While our primary contact at New Haven Health is enthusiastic about usefulness of the wristband, our next step is to test the effectiveness of the solution. This means distributing wristbands at the hospital and following up on a sample of patients on their usefulness.