Learning objectives:

1. Describe the roles of acute pain, cravings, and withdrawal in self-directed discharge from the hospital among persons with substance use disorders.
2. Discuss nursing and interdisciplinary interventions which when implemented are designed to decrease rates of self-directed patient discharge.
3.  

Abstract:

Patients with substance use disorders are more likely than those without to have a self-directed hospital discharge (also known as discharge against medical advice), putting them at risk for poor health outcomes including progressing illness, readmissions, and death. In this symposium, Dr. Compton will begin by presenting the results of original research exploring the role of acute and chronic pain in self-directed discharges in patients who use opioids, and the progression of infectious morbidity. Ms. McFadden will discuss how interruptions to care, including self-directed discharges, result in poorer health outcomes and burden low-barrier clinics with limited resources. Dr. Aronowitz will present on approaches to treating acute pain and withdrawal in hospitalized patients with opioid use disorder to avoid self-directed discharge and consider the role of stigmatizing nursing care in self-directed discharges. Finally, Dr. French will discuss the role of interdisciplinary hospital care teams in addressing stigma and self-directed discharge among persons who use substances. Across these presentations, attendees will come to appreciate the roles of acute pain, craving and withdrawal in self-directed discharge from the hospital among persons with substance use disorders and learn about nursing and interdisciplinary interventions designed to decrease rates of self-directed discharge among this patient population. The symposium faculty believe that each hospital admission represents an opportunity to provide evidence-based harm reduction and treatment interventions to people who use drugs. Thus, addressing self-directed discharges is critical to improving health outcomes in this population.