The impact of access to addiction specialist on attitudes, beliefs and hospital-based opioid use disorder related care: A survey of hospitalist physicians.

Background: Hospitalizations for complications related to opioid use disorder (OUD) are increasing. Hospitalists care for most hospitalized patients in the United States, yet little is known about their attitudes, beliefs, and clinical practices regarding OUD-related care.
Methods: We distributed an online survey to hospitalists in the United States to measure how access to addiction specialists affected attitudes and beliefs regarding hospital-based OUD care, OUD screening practices, naloxone prescribing, and buprenorphine initiation.
Results: Among 262 respondents, 67.9% ( n  = 178) reported having access to addiction specialists. While 84.5% ( n  = 221) reported often or always caring for patients with OUD, 48.2% ( n  = 126) rarely or never screened for OUD, 57.1% ( n  = 149) rarely or never prescribed or recommended naloxone as harm reduction, and 88.9% ( n  = 233) rarely or never initiated buprenorphine. In multivariable analyses, compared to hospitalists without access to addiction specialists, hospitalist with access to addiction specialists were more likely to feel supported to screen and refer patients to treatment (aOR = 4.4, 95% CI 2.1 - 9.1; ρ  < 0.001), to be aware of local treatment resources (aOR = 3.4, 95% CI 1.8 - 6.3; ρ  < 0.001), and refer patients to treatment (aOR = 3.0, 95% CI 1.7 - 5.6; ρ  < 0.001).
Conclusions: Many hospitalists do not provide life-saving treatment to patients with OUD. Access to addiction specialists may increase provision of OUD-related care by hospitalists.