February 12, 2024

Among people with opioid use disorder (OUD) who initiated a medication for opioid use disorder (MOUD) in an emergency department (ED), half remained engaged in OUD treatment a month later, twice the engagement rate of those who did not start a MOUD while at the emergency department. About 86% of people with OUD treated in an ED who were offered a MOUD initiated it before discharge, and nearly 50% remained engaged in treatment 30 days later. Of those who were not treated with a MOUD during the ED visit, 23% remained engaged in treatment. 

The treatment retention rate was discovered in an analysis of outcomes for 464 people with OUD who had an ED visit at one of seven California EDs between April 1, 2021, and June 30, 2022. At the ED visits, 398 (85.8%) were treated with a MOUD and 66 (14.2%) were not. In total, 339 people were given a prescription for buprenorphine to fill after the ED visit.   

• Of the 398 treated with a MOUD at the ED visit, 198 (49.7%) remained engaged in OUD treatment 30 days later, and 200 (50.3%) were not engaged. 

• Of the 66 not treated with a MOUD at the ED visit, 15 (22.7%) remained engaged in OUD treatment 30 days later, and 51 (77.3%) were not engaged.   
   

These findings were reported in “Emergency Department Access to Buprenorphine for Opioid Use Disorder” by Andrew A. Herring, M.D.; Allison D. Rosen, Ph.D.; Elizabeth A. Samuels, M.D., MPH; and colleagues. They conducted a multisite cohort study in seven California emergency departments participating in a statewide implementation project to improve access to MOUD treatment. All 464 individuals were offered a MOUD treatment for OUD (either in ED administration, prescription, or both). Treatment engagement at 30 days was determined by consumer report or clinical documentation. The median age for the group was 36 years. About 85% of the individuals were enrolled in Medicaid. More than half (57.8%) had unstable housing. The majority (71.5%) had a comorbid mental health condition. 

The full text of “Emergency Department Access to Buprenorphine for Opioid Use Disorder” was published January 29, 2024 by JAMA Network Open.