"We're All in This Together": A Mixed-Methods Study of Provider and Patient Perceptions of Emergency Care for Opioid Use Disorder.
Ariana McFarland, Lisa Chan, Pooja Lalwani and 4 others
PMID 41919671WHAT IT FOUND
People with opioid use disorder described avoiding emergency care due to fear of judgment and pain dismissal.
Providers reported feeling helpless and unsafe. Both groups agreed addiction is a disease, but disagreed on whether naloxone changes behavior or if disclosure is honest.
Key findings
01People with opioid use disorder often view emergency services as a last resort and avoid hospitals because they feel judged, dismissed, or unsafe, leading them to conceal substance use history.
02Most people with opioid use disorder resented receiving naloxone, describing the experience as painful and disruptive, with some stating they would prefer death to the withdrawal symptoms caused by reversal.
03Providers frequently felt they lacked adequate training and resources to treat pain and addiction, leading to frustration and a sense of helplessness, while patients felt their pain was undertreated due to stigma.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was conducted in a single urban New England academic medical center, which has higher access to opioid use disorder treatment and lower stigma than many other regions, limiting generalizability. The sample had limited racial and ethnic diversity. Social desirability bias may have influenced responses, despite efforts to mitigate it. Participants provided one-sided perspectives; accusations of bias or dishonesty from either group must be considered carefully. The study reports perceptions and experiences, not clinical outcomes or efficacy of specific interventions.
Declared interests
No conflicts of interest were reported by the authors.
The easy way to misread this
Do not interpret the patients' concealment of substance use as evidence of 'drug-seeking' behavior or dishonesty for secondary gain. The study found that patients hid this information primarily because they feared being judged, having their pain dismissed, or receiving inadequate care.