Evidence map›Paper›PMID 42151526›Full record

ArticleJournal of general internal medicine2026

Failure to Treat Opioid Use Disorder and Opioid Withdrawal Associated with Patient-Directed Discharge in People with Injection-Related Infections.

Edward C Traver, Oshozimhede E Iyalomhe, Habib O Ramadhani, Jasmine Stevens, Meghan Derenoncourt, Ishan Vaish, Hannah Flores, A Wendy Fujita, Sumitha Raman, Alaina Steck and 8 more

Abstract read
PubMed Publisher
In one paragraph

Article in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Edward C TraverInstitute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA. etraver@ihv.umaryland.edu.ORCID http://orcid.org/0000-0001-7127-3872
Oshozimhede E IyalomheInstitute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA.
Habib O RamadhaniInstitute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA.
Jasmine StevensUniversity of Maryland School of Medicine, Baltimore, MD, USA.
Meghan DerenoncourtInstitute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA.
Ishan VaishUniversity of Maryland School of Medicine, Baltimore, MD, USA.
Hannah FloresUniversity of Maryland Medical Center, Baltimore, MD, USA.
A Wendy FujitaDivision of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA.
Sumitha RamanDepartment of Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Alaina SteckDepartment of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA.
Irene KuoDepartment of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Jillian S CatalanottiDepartment of Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Joseph E CarpenterDepartment of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA.
Rebecca ReeceDivision of Infectious Diseases, West Virginia University School of Medicine, Morgantown, WV, USA.
Henry MasurCritical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA.
Marie-Claude C LavoieInstitute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA.
Sarah M KattakuzhyInstitute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA.ORCID http://orcid.org/0000-0002-3433-3597
Elana S RosenthalInstitute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA.

Funding

CLC NIH HHS 75N90023C00013
6 · The paper itself

Abstract

backgroundPeople who inject drugs (PWID) are frequently hospitalized with acute infections. Patient-directed discharge (PDD) is common among people with injection-related infections and is associated with rehospitalization and death. Opioid withdrawal and pain are common reasons for PDD among PWID but approaches to reduce PDD among people with injection-related infections are lacking.

objectiveTo measure if inpatient treatment of opioid use disorder (OUD) and opioid withdrawal is associated with lower PDD rates among people hospitalized with infections from injection drug use.

designMultisite retrospective observational cohort. Multivariable Poisson regression models were used to compute adjusted incidence rate ratio (aIRR) for factors associated with PDD.

participantsAdults hospitalized for ≥ 2 days at four academic medical centers for a bacterial or fungal infection caused by injection opioid use between January 1, 2018, and March 31, 2023. MAIN MEASURES: Drug toxicology testing, presence of opioid withdrawal, treatment of opioid withdrawal, receipt of medication for OUD (MOUD; buprenorphine or methadone), duration of hospitalization, and discharge type (planned or patient-directed). KEY

resultsPDD occurred in 25% of the 1447 hospitalizations. Hospitalizations with PDD were shorter than those with planned discharge (median 6 v. 18 days, p < 0.001). Compared to those without opioid withdrawal, PDD rates were highest for participants with untreated opioid withdrawal (aIRR = 2.73, 95%CI: 1.49-5.02) and participants with withdrawal treated with only non-opioids (aIRR = 2.54, 95%CI: 1.89-3.42), and less elevated for participants with withdrawal treated with opioids (aIRR = 2.00, 95%CI: 1.46-2.75). Participants who received MOUD during the hospitalization had lower rates of PDD than those who did not (aIRR = 0.25, 95%CI: 0.19-0.33).

conclusionsAmong people hospitalized with infections from injection opioid use, over one quarter experienced PDD. Lower rates of PDD were associated with MOUD treatment and opioid withdrawal treatment.

Indexed as

infectionsopioid use disorderpatient-directed discharge

Identifiers

PMID42151526

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.