Navigating Uncharted Waters of In-Hospital Substance Use

Background: It is estimated that 1 in 9 patients hospitalized have a substance use disorder (SUD), and use of substances in the hospital is likely more common than realized. However, policies and procedures regarding inpatient use of substances vary and may have detrimental effects on patients. Objective: To understand the policies about in-hospital substance use at the 86 hospitals with Accreditation Council of Graduate Medical Education-accredited addiction medicine fellowships and elaborate what might be better responses. Design: Cross-sectional survey study. Methods: There were 77 respondents from 55 institutions (63.9%) that have an addiction medicine fellowship. The majority were physicians (93.5%), worked inpatient (81.8%), and had a board certification in addiction medicine (76.6%). Of these, 75.3% had an inpatient addiction medicine service and 71.4% had inpatient protocols for medications for opioid use disorder. The authors addressed hospital policies and procedures involv more...