This month, CanadiEM is featuring an article from the Canadian Journal of Emergency Medicine that looks at substance-related ED presentations and the need for direct referral to a rapid-access addiction services. Recent national data shows that substance-related emergency department visits are rapidly increasing.1 Despite this finding, previous studies show that many EDs do not have referral protocols for rapid-access addiction services.2
A prospective cohort study was conducted by Hann et al. to better characterize substance-related ED presentations and assessed the need for a rapid-access addiction clinic.3 Specifically, the study evaluated whether the ED health care team would have referred a patient to an on-site rapid-access addiction clinic, if one were available.
The results are highlighted in our visual abstract. 458 patient encounters were included in the analysis, of which, the majority (64%) were male. Alcohol was the most commonly reported substance of problematic or high-risk use (60%). The ED health care team indicated “Yes” for rapid-access addiction clinic referral from the ED for 66% of enrolled patients, with a mean of 4.3 patients referred per day during the study period (June to August 2018).
Overall, this study highlights the need for a rapid-access addiction clinic, given that four ED patients would have been referred per day, and potentially benefiting an underserved patient population.
To read the full article, visit https://doi.org/10.1017/cem.2019.453
- 1.Government of Canada . Overview of national data on opioid-related harms and deaths. Canada.ca. Published December 12, 2018. Accessed November 31, 2019. https://www.canada.ca/en/health-canada/services/substance-use/problematic-prescription-drug-use/opioids/data-surveillance-research/harms-deaths.html
- 2.Elliott K, W K, Basu A, Sabbatini A. Transitional care clinics for follow-up and primary care linkage for patients discharged from the ED. Am J Emerg Med. 2016;34(7):1230-1235. doi:10.1016/j.ajem.2016.03.029
- 3.Hann J, Wu H, Gauri A, et al. Identification of emergency department patients for referral to rapid-access addiction services. CJEM. 2020;22(2):170-177. doi:10.1017/cem.2019.453