Yale opioid research will make impact

Opioid addiction is a crisis nationwide, from large urban cities to small rural towns and public health officials here are looking for ways to combat it and get people the treatment they need.

Opioid addiction is a crisis nationwide, and public health officials here are looking for ways to combat it.

Yale researchers believe part of the answer lies in hospital emergency rooms, saying that starting treatment there with medication is not only the most cost-effective way to treat patients but helps get them on the road to recovery.

There is good reason for their thinking.

People with opioid addiction often seek treatment in emergency departments for overdoses and other ailments.

Researchers found that those who receive buprenorphine — a medication that reduces cravings for drugs — in emergency rooms have lower health care costs during the following month than those who were referred to treatment services or received a brief intervention, according to a new analysis of a Yale randomized clinical trial.

The analysis was published recently in the journal “Addiction.”

It compared the probable health care costs for patients during the 30 days following their emergency room visit, which included emergency care, addiction treatment, inpatient and outpatient costs and medications.

Patients who received buprenorphine incurred an average cost of $1,752, compared with $1,805 for those who got brief interventions and $1,977 for those who received referrals alone.

Doesn’t sound like much of a savings but when the number of addicted people in Connecticut are factored in, it adds up. Last year alone, 917 people died from accidental drug overdoses in Connecticut. And the state, like the nation, has seen its number of opioid-induced emergency room visits soar — so any effort to reduce and treat addiction and help save lives is saluted.

In the fourth quarter of 2014, there were 246 opioid-related emergency room visits per 100,000 people in the state, well above the national rate of 183 per 100,000 people during the same quarter, according to the federal Agency for Healthcare Research and Quality.

Connecticut ranked in the top 25 percent of states with the highest opioid-related emergency room visit rates among men in 2014 and with the highest rates of opioid-related inpatient hospital stays for both men and women. The rate for women was among the middle 50 percent of the nation, data show.

Researchers also found other advantages, such as that those who started the medication in an emergency room were nearly twice as likely to be enrolled in an addiction treatment program and used opioids for fewer days during the 30 days following their ED visits.

The findings at Yale New Haven Hospital are significant, said Susan Busch, professor of health policy at Yale School of Public Health and first author of the study, “because relatively few people with opioid use disorder receive treatment, and even fewer receive the most effective treatments like buprenorphine.”

Busch said “only about 20 percent of people with opioid use disorder are in treatment.”

That is a huge problem. Yale’s research on effective opioid treatment shows it could make a ‘significant impact’ in Connecticut.

But for it to do so, opioid-addicted people must come forward and get the help they need.

Patients who received buprenorphine incurred an average cost of $1,752, compared with $1,805 for those who got brief interventions and $1,977 for those who received referrals alone.