The Substance Use Intervention Team: A Preliminary Analysis of a Population-level Strategy to Address the Opioid Crisis at an Academic Health Center

Abstract

Objective: In 2017, an academic health center in Chicago launched the multidisciplinary Substance Use Intervention Team (SUIT) to address opioid misuse across 18 inpatient units and in a new outpatient addiction medicine clinic. This report assesses the first 5 months of implementation and associations with patient health and healthcare utilization. Methods: Patient demographic and screening data were extracted from the administrative data warehouse of the electronic health record (EHR) infrastructure. Distribution of sample characteristics for positive initial screens for opioid misuse was tested against those of all patients screened using a 2-tailed test of proportions (P\u200a<\u200a0.05). A second analysis compared length of stay and 30-day readmissions within a cohort of patients with a secondary diagnosis of substance use disorder. Results: Between November, 2017 and March, 2018, 76% of 15,054 unique patients were screened, 578 had positive scores on the Alcohol Use Disorders Identification Test and Drug Abuse Screening Test, 131 had positive scores for opioid misuse, and 52 patients initiated medication treatment. Patients with a secondary diagnosis of substance use disorder who received a SUIT consult (n\u200a=\u200a161), compared with those who did not (n\u200a=\u200a612), had a shorter average length of stay (5.91 vs 6.73 days) and lower 30-day readmission rate (13.6% vs 15.7%). Conclusion: Leveraging the EHR to conduct standardized screenings and treatment has helped identify an at-risk population—disproportionately younger, black, and male—and treat new cases of opioid and substance misuse. The intervention indicates trends toward a shortened length of stay, reduced 30-day readmissions, and has linked patients to outpatient care.