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Addiction counseling delivered right in the hospital can improve outcomes and count as low-cost addiction treatment, according to a new analysis in JAMA Network Open.
The program helped more patients start treatment for opioid use disorder and stay connected to care after discharge, while adding only about $162 per patient.
Both halves of that finding matter. The counseling improved real outcomes, and it did so cheaply, which is the kind of value that lets hospitals, including the public and safety-net hospitals that serve many uninsured and Medicaid patients, actually offer it.
What the Counseling Program Found
The program is called START, short for Substance Use Treatment and Recovery Team.
It pairs an addiction medicine specialist with a care manager who counsels a hospitalized patient, helps them start medication for opioid use disorder before discharge, and links them to follow-up care, including a weekly check-in call for a month after they leave.
Researchers co-led by Cedars-Sinai used a computer model built on a prior multi-site randomized trial that enrolled 414 patients at Cedars-Sinai in Los Angeles, the University of New Mexico Hospital, and Baystate Health in Massachusetts.
Compared with usual care, patients who worked with START were more likely to begin opioid use disorder treatment and to connect with follow-up care after discharge.
The cost worked out to roughly $162 more per patient, and about $15,750 per additional year of good health gained.
That figure sits well below the thresholds health economists generally use to call something cost-effective.
Why This Matters If Cost Is Your Barrier
Hospitals are often where addiction first gets addressed, especially for people who are uninsured, underinsured, or covered by Medicaid.
A counseling model that adds little cost is far easier to adopt and keep running, which can widen access to help that would otherwise never reach people who cannot pay private-pay rates.
Medication for opioid use disorder (sometimes shortened to MOUD or MAT) means FDA-approved medicines such as buprenorphine, methadone, or naltrexone that reduce withdrawal and cravings and lower overdose risk.
Starting it in the hospital, with counseling and a clear follow-up plan, is one of the most effective steps available.
How to Access Help Like This
If you or someone you love is in the hospital, ask whether it has an addiction medicine or addiction consult service.
Ask specifically about starting medication for opioid use disorder before discharge and about a written follow-up plan.
Medicaid insurance covers substance use treatment, including medication for opioid use disorder, in every state.
Medicare and many ACA marketplace plans cover addiction treatment too, so it is worth confirming your benefits before assuming a program is out of reach.
Free and Low-Cost Treatment Options
– Check whether your state’s Medicaid program covers rehab and medication for opioid use disorder.
– Search free and low-cost treatment centers near you.
– Contact SAMHSA’s national helpline at 1-800-662-4357, which is free, confidential, and open 24/7.
Wherever you are in the country, you can find treatment nearby. Rehabs.org lists free and low-cost rehab centers nationwide. Call
800-914-7089
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to find affordable care today.
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