The Consult for Addiction Treatment and Care in Hospitals program (CATCH) is helping to reduce the number of deaths from drug overdoses in the U.S., according to a new study. The study published in JAMA Internal Medicine finds that 80 percent of people with opioid use disorder (OUD) do not receive evidence-based life-saving medications. Additionally, despite having a wide range of medication options for addiction, structural and social barriers continue to impede access to treatment. As a result, more than 100,000 people in the U.S. die from drug overdoses each year.

To help determine the effectiveness of CATCH, researchers at NYU Grossman School of Medicine partnered with the New York City public hospital system to investigate if a program offering addiction care to patients with substance use disorder while they are in the hospital could lead to better uptake of OUD treatment after discharge.

The results found that CATCH was not only highly effective in the management and treatment of OUD, but the odds of patients initiating medication for opioid use disorder treatment post-discharge were eight times higher, and the odds of continuing treatment were nearly six times higher, compared with usual care. 

"Addiction consult programs like CATCH have tremendous potential to reduce the negative consequences of untreated substance use disorder," said Jennifer McNeely, MD, principal investigator of the study and associate professor in the Departments of Population Health and Medicine at NYU Langone. "We have highly effective medications for treating opioid use disorder and preventing overdose, but far too few patients are receiving them. It is our hope that programs like CATCH will be replicated, reimbursed, and rolled out at hospitals across the country, to transform hospital care for patients with substance use disorder."

McNeely noted that people with untreated opioid use disorder have high rates of hospital admissions, which can be an opportunity for starting medications for OUD treatment and improving engagement with medical and harm reduction services. She added specialty consult services are common in the hospital, but rare for addiction. Programs like CATCH help fill this gap, providing specialized care to reduce the chances of overdose or death. 

To determine the effectiveness of the program, investigators assessed whether patients who were not already in treatment before hospitalization received medication for OUD in the first 14 days post-hospital discharge, as well as continuation with treatment 30 days after initiation. 

The study found that the majority of identified patients were male at 73 percent with an average age of 47 years old. Approximately two-thirds of patients had three or more chronic medical conditions and at least one diagnosis of serious mental illness. In the past three years, half had three or more hospitalizations and 58 percent had three or more visits to the emergency department, while less than half had received any medications for OUD previously.

When brought into the CATCH program, 11 percent of patients with eligible admissions started OUD medications following discharge, compared with less than 7 percent when hospitals were providing usual care. Out of all eligible admissions, 7.5 percent of patients in CATCH hospitals remained in treatment for at least 30 days, compared to 5.5 percent in usual care. 

"NYC Health + Hospitals' Consult for Addiction Treatment and Care in Hospital (CATCH) teams engage patients admitted into the hospital who exhibit symptoms of substance use disorder,” said NYC Health + Hospitals Medical Director of Substance Use Disorder Services Dan Schatz, MD, MS. “They offer compassionate, wrap-around, cutting-edge addiction care. We have begun thousands of patients on lifesaving buprenorphine treatment through this program, and we are grateful to NYU for partnering with us on a study to show what we have long witnessed every day. 

“The impact of programs like CATCH is indisputable, both in direct clinical outcomes and in catalyzing culture change within hospitals to make them the gold standard of care. These teams, located at six of our hospitals, are bringing care directly to patients who need it the most, ensuring that patients have the resources and treatment that they need," Dr. Schatz said.

McNeely noted retention in treatment after six months was low for both the CATCH patients at 3.2 percent and control patients at 2.4 percent. However, she is pleased with the overall results, as are other medical professionals who have supported the program. She added there remains a need for further efforts to improve hospital and community-based services for OUD treatment.