Substance Use Disorder Presentations and Referral Patterns for an Emergency Department in a Northern Ontario City

Abstract

Objectives: Substance use, both alcohol and opioids, is higher in Sudbury, Ontario than in the remainder of the province and the numbers increased during COVID-19. In response to increased use during the pandemic, the hospital developed the Addictions Medicine Consult Service (AMCS) to complement the existing addiction services. After a full year of operation, a program evaluation was completed to determine the effectiveness and gaps of the AMCS, to enact changes for service improvement. Methods: A retrospective chart review was conducted. Analysis of the characteristics and frequency of people presenting with substance use to the emergency department, along with referrals to addiction services, was undertaken. Results: Fewer than seven percent of patients presenting with substance use in the emergency department were referred to the AMCS. The majority used alcohol and were housed, followed by those who used fentanyl who were unlikely to be housed. Many patients were referred to Crisis, the multidisciplinary mental health team in the hospital, which is available 24/7 but which does not include addictions expertise. Conclusions: Changes to service delivery to increase the use of the AMCS were implemented to improve service accessibility and delivery of care. These included nursing daily rounds in the emergency department and adding more direct links with resources in the community.

Keywords

• program evaluation
• addictions care
• emergency department