{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T06:47:10Z","timestamp":1785739630222,"version":"3.56.0"},"reference-count":39,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T00:00:00Z","timestamp":1785628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T00:00:00Z","timestamp":1785628800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["shmpublications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hospital Medicine"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Up to 40% of patients with substance use disorder report using non\u2010prescribed drugs when hospitalized. In\u2010hospital substance (IHSU) use is associated with poor outcomes and raises safety concerns for healthcare providers. Despite its prevalence, little guidance exists regarding best practices in responding to IHSU. Here, we present a case\u2010based, bioethical evaluation comparing two possible approaches to address IHSU: (1) a \u201ccontainment\u2010focused\u201d approach that relies on involvement of security and uses restrictive interventions to prevent further drug use, and (2) a \u201cpatient\u2010first\u201d approach, which seeks to understand and address underlying reasons for IHSU and makes calling security a last resort.<\/jats:p>","DOI":"10.1002\/jhm.70410","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T06:23:16Z","timestamp":1785738196000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Addressing in\u2010hospital substance use: A bioethical evaluation of two possible approaches"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8859-6974","authenticated-orcid":false,"given":"John C.","family":"Messinger","sequence":"first","affiliation":[{"name":"Department of Medicine University of California San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taylor","family":"Baisey","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine at San Francisco General Hospital, Department of Medicine University of California San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Sluser","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine at San Francisco General Hospital, Department of Medicine University of California San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin A.","family":"Barsky","sequence":"additional","affiliation":[{"name":"University of California College of the Law San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8727-0289","authenticated-orcid":false,"given":"Marlene","family":"Martin","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine at San Francisco General Hospital, Department of Medicine University of California San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie W.","family":"Suen","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine at San Francisco General Hospital, Department of Medicine University of California San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,2]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2015.1424"},{"key":"e_1_2_7_3_1","unstructured":"Centers for Disease Control and Prevention. 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