LAUSR

To the Editor: T he paper by Priest and McCarty (2019) provides valuable insights into Addiction Medicine Consult Services (AMCS) and the care delivered to hospitalized individuals with substance use disorders (SUDs). We commend the authors for this and also wish to illuminate further on this topic. As part of a larger-quality improvement initiative focused on the acute inpatient psychiatric units, we retrospectively examined the medical records of patients admitted to acute inpatient psychiatric units at St. Paul’s Hospital, an inner-city hospital, in Vancouver, British Columbia, who had been referred to the AMCS. It consisted of certified addiction specialist physicians, interdisciplinary trainees and fellows, a clinical nurse educator, and 2 social workers—one who provides dedicated support to psychiatric inpatients. The Analytics and Decision Support Service at St. Paul’s Hospital identified there were 391 psychiatric inpatient referrals to the AMCS between April 30, 2016 and May 1, 2017, of which 284 individuals met the criteria. Subsequently, this service randomly selected 45 medical records for evaluation. The research team developed a data collection tool along with a code book to extract data on the patients’ characteristics, reasons for referrals, and on the care provided from the patients’ medical records. After retrieving the data, R version 3.4.4 was used to generate descriptive statistics. The chart abstraction was approved by the Providence Health Care/University of British Columbia Behavioural Research Ethics Board. Table 1 shows those in this study were predominantly male (n1⁄4 29, 64.4%) and the vast majority of individuals (n1⁄4 40, 91%) had more than 1 documented SUD. Nicotine use disorder was the most common diagnosis (n1⁄4 32, 72.7%), followed by stimulant use disorder (n1⁄4 30, 68.2%) and opioid use disorder (n1⁄4 23, 52.3%). Most patients were referred due to their opioid use (n1⁄4 27, 60%), including 4 (8.9%) for the continuation of opioid agonist therapy (OAT). Sixteen individuals (35.6%) were receiving an OAT at the time of discharge, but only 7 (15.6%) had a documented follow-up plan for this treatment. Take-Home Naloxone (THN) kits were offered to 12 individuals (26.7%) and most