1. Home
  2. Program Models
  3. Support Hospital Opioid Use Disorder Treatment (SHOUT)

Support Hospital Opioid Use Disorder Treatment (SHOUT)

This Texas program identifies hospital inpatients with opioid use disorder and links them to treatment and harm reduction resources

Hospitalization presents an often overlooked and underutilized opportunity for medical intervention for those suffering from opioid use disorder (OUD). As part of the Be Well Texas initiative to provide easily accessible treatment and recovery services statewide, the Support Hospital Opioid Use Disorder Treatment (SHOUT) program identifies hospital inpatients with OUD, initiates buprenorphine therapy, and links them to outpatient addiction care. The program also provides education and resources in harm reduction and assistance in planning a sustainable recovery. Recent SHOUT statistics show that 60 percent of those who initiated treatment with buprenorphine entered a treatment program after discharge from the hospital.

As described in this academic study, SHOUT now operates in four Texas hospitals and has started over 3,000 patients with OUD on buprenorphine. A toolkit based on the program provides an overview of the current epidemiology of OUD, a primer on opioids, addiction and treatment, along with  resources for initiating treatment during hospitalization and promoting hospital-based opioid use disorder treatment. SHOUT hosts a YouTube channel with training videos describing all facets of program implementation and operation. Contact information is available at the program's website.

By providing person-centered care to patients with OUD in inpatient settings, hospitalization can become an opportunity to improve health, initiate treatment, and facilitate linkages to capable community clinics for ongoing addiction care.

Continuum of Care
Treatment
Recovery
Harm Reduction
Type of Evidence
Peer-reviewed
Response Approach
Early Intervention
Medications for Opioid Use Disorder
Peer-reviewed Article
The Support Hospital Opioid Use Disorder Treatment (SHOUT) Texas program implementation strategy for expanding treatment for hospitalized adults with opioid use disorder
Related Resources
Planning and Designing the Improving Addiction Care Team (IMPACT) for Hospitalized Adults with Substance Use Disorder
The Role of Rural Hospitals in Addressing Opioid and Other Substance Use Problems
Hospital Inpatient Stays Related to Opioid Use Disorder and Endocarditis, 2016
Clinical Perspectives on Hospitals' Role in the Opioid Epidemic
Addressing Opioid Use in Rural Communities: Examples from Critical Access Hospitals
Clinical Impact, Costs, and Cost-effectiveness of Hospital-based Strategies for Addressing the US Opioid Epidemic: A Modelling Study
Addressing Opioid Use in Rural Communities: Examples from Critical Access Hospitals

Evidence of Program Effectiveness

"Between 2020 and 2023, the SHOUT Texas program expanded to three additional Texas hospital sites, resulting in 3065 hospitalized adult patients starting treatment for OUD. More than 2500 interprofessional clinicians (physicians, nurses, physician assistants, social workers) received SHOUT training regarding inpatient initiation of OUD treatment, with 241 attending at least one hour-long Project ECHO session...Implementation of the SHOUT Texas model across diverse hospital settings resulted in significant provider engagement and rapid increase in the number of patients initiating OUD treatment during hospitalization. Lessons learned from this novel approach may be applicable in other states, particularly those that have not expanded Medicaid." Moriates et al., 2024.