Addiction Consult

The Addiction Medicine team is expected to arrive by 8:30am on weekdays and meet with the team in IRD 434.  The residents and students will be overseen and led by our NP Marie Eugenio as well as the rounding attending listed on Amion (amion>la gen>addiction medicine).

• The Addiction Medicine Service is a daily service with NP and Attending coverage and inpatient rounds everyday, except for weekends and holidays when there is just an Attending on call.  Given the nature of our consults (ED/inpatient/clinics) and to facilitate timely consults and recommendations/management patients are seen and staffed continuously throughout the day with AM rounds on new patients and follow-ups on old patients in the morning

• Specific times will be coordinated with the attending and our NP but generally AM rounds begin ~9-930am

• Consults are generated either from calls to our service Voip held by our NP (x91822), MS teams messages to the Attending or NP and via our pager for ED consults.

• An MS teams chat will be started each day with the attending, NP and learners on that day

• Throughout the rotation there will be scheduled and unscheduled teaching and didactics including lectures given by our faculty

• Tuesday mornings at 9am-1130am we run a Contingency Management program at the DMH Building in DTLA.  We expect you to try to attend one time during your rotation. There are also daily outreach opportunities with our Substance Use Navigators and CENS workers.

• We run an injectables clinic (ie Brixadi, Vivitrol, Sublocade) M-Weds in UCC run by our pharmacy resident and staffed by the Attending and our Pharmacist David Dadiomov.

• Rotators should approach all patients holistically in terms of understanding their reason for admission, PMHx, current inpatient reason for admission as well as their current living situation, substances used, how they’re used (ie nasal, IV, oral etc), history of withdrawal as well as any prior MAT (medications for addiction treatment) they have been on and failures or successes on those medications

• Given many of our patients are extremely high risk for unwanted pregnancy, HCV, HIV we also focus on harm reduction (ie clean needles, fent test strips) as well as encouraging testing for transmissible diseases and offering birth control/emergency contraception for pts with child-bearing potential

• Consult recommendations are given directly to the team either via MS team or talking directly to the team

• Notes should be signed by the end of the day