Treating patients with Opioid Use Disorder (OUD) in the Emergency Department

I am glad to be welcoming all of you to the first Journal Club of the 24-25 academic year.  While I know I have no chance of living up to the precedent that Dr. Graffeo set in leading this, at least with the academic basis which he laid as well as the extensive assistance he provided in transitioning to this new role, I hope I can keep up some semblance of the previous standard at least a little while. 

For our first journal club we are going to tackle a few articles that delve into the number 1 public health crisis currently facing our country, which continues to be the opioid crisis.  Currently almost 100,000 Americans die every year from drug overdose, and at least 80% of those deaths are opioid related.  When this was first finally acknowledged as a public health emergency in the mid 2010s that number was half that, and so the death toll only continues to get worse.

We in the house of medicine have at least some responsibility for the initial rise of this crisis, and while the current trajectory may not be our primary responsibility, we certainly should do what we can to curb this sad epidemic.  This month’s articles will include an article on the 1 year mortality among patients presenting after an opioid overdose, the lack of efficacy of opioids in treating chronic orthopedic pain, and the efficacy of ED initiated buprenorphine.