Patient navigation for substance use disorder (SUD) and co-occurring mental illness is a cost-effective intervention.

A new study by a group at the University of Maryland Medical Center in Baltimore demonstrates the value of their NavSTAR model for substance use navigation in the emergency department (ED). NavSTAR recruited patients through an addiction consult service and provided patient navigation focused on engagement in SUD treatment. Navigators were community health outreach workers with specialty competency in working with people who use drugs and have co-occurring mental illnesses. Patient navigation started before hospital discharge and continued for up to 3 months post-discharge.

Key findings include:

SUD Navigation for hospital/ED patients is cost-effective.

Cost measures included the cost of the 3-month NavSTAR patient navigation intervention and the cost of all inpatient days and ED visits over a 12-month period. NavSTAR generated $17,780 in savings per participant.

SUD Navigation reduces costs through decreased inpatient admission rates and repeat ED visits.

Inpatient admission rates were 26% lower during a 12-month observation period. Emergency department visits were 44% less likely for patients receiving patient navigation.

SUD Navigation reduces healthcare utilization through improved engagement in outpatient treatment.

After discharge, 50% of patients engaged in SUD treatment compared to only 30% in the control arm.


These findings on cost and utilization strengthen the case for treatment we already know saves lives. When a patient is on methadone or buprenorphine, their risk of death immediately goes down! Please share these findings with hospital leaders to encourage them to make navigators and treatment of SUD part of the standard of care in your ED.