Inpatient Opioid Withdrawal: A Qualitative Study of the Patient Perspective

Abstract

Abstract Background and Objectives Opioid withdrawal is common among hospitalized patients. Those with substance use disorders exhibit higher rates of patient-directed discharge. The literature lacks information regarding the patient perspective on opioid withdrawal in the hospital setting. In this study, we aimed to capture the patient-reported experience of opioid withdrawal during hospitalization, and its impact on the desire to continue treatment for opioid use disorder after discharge. Methods We performed a single-center qualitative study involving semi-structured interviews of hospitalized patients with OUD experiencing opioid withdrawal. Investigators conducted in-person interviews utilizing a combination of open-ended and dichotomous questions. Interview transcripts were then analyzed with open-coding for emergent themes. Results Nineteen interviews were performed. All participants were linked to either buprenorphine (79%) or methadone (21%) at discharge. Eight of nineteen patients (42%) reported a patient-directed discharge during prior hospitalizations. Themes identified from the interviews included: 1) opioid withdrawal was well-managed in the hospital; 2) participants appreciated the receipt of medication for opioid use disorder (MOUD) for withdrawal symptoms; 3) they valued and felt cared for by healthcare providers; and 4) most participants had plans to follow-up for opioid use disorder treatment after hospitalization. Conclusions In this population historically reporting high rates of patient-directed discharge, participants reported having a positive experience with opioid withdrawal management during hospitalization. Several individualized MOUD induction strategies were observed. All participants were offered MOUD at discharge and most planned to follow-up for further treatment.