Hospital addiction consultation service may improve outcomes at low cost

by Cedars-Sinai Medical Center

edited by Lisa Lock, reviewed by Andrew Zinin

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Helping hospitalized patients begin treatment for opioid use disorder may improve outcomes at a reasonable financial cost, according to a study co-led by investigators at Cedars-Sinai Health Sciences University. The analysis, published in JAMA Network Open, suggests the hospital-based addiction consultation service known as START (Substance Use Treatment and Recovery Team) is cost-effective and clinically effective, based on findings from a prior randomized trial.

Investigators used a computer-based model to analyze the clinical trial data and evaluate health care costs and patient outcomes over one year. Compared with patients who received standard or usual care, those who received START were more likely to begin treatment for opioid use disorder and connect with follow-up care after discharge. Compared with usual care, START costs an additional $162 per patient and approximately $15,750 per additional year lived in good health—well below commonly accepted thresholds for cost-effectiveness.

"Hospitalization is a critical opportunity to begin treatment for opioid use disorder, yet most patients are discharged without it," said Teryl Nuckols, MD, MSHS, director of the Division of Internal Medicine at Cedars-Sinai and the study's senior author. "While new care models can be costly to implement, our findings suggest START delivers meaningful health benefits for a relatively modest additional investment—providing strong value for patients and health systems alike."

The authors said additional research is needed to better understand how hospitals can overcome barriers to implementing START and similar addiction consultation services. This information can inform hospital leaders and health care policymakers making decisions about the role of addiction consultation services in the care of hospitalized patients with opioid use disorder.

Publication details

Adeyemi Okunogbe et al, Cost-Effectiveness of the START Hospital Addiction Consultation Service for Opioid Use Disorder Treatment, JAMA Network Open (2026). DOI: 10.1001/jamanetworkopen.2026.11324

Journal information: JAMA Network Open

Key medical concepts

Opioids and Opioid Use Disorder (OUD)

Clinical categories

Hospital medicinePsychiatry Provided by Cedars-Sinai Medical Center Who's behind this story?

Lisa Lock

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