Scaling Emergency Department Opioid Use Disorder Treatment Across California to Reduce Overdose Deaths, 2019-2023

Area of Science:

• Public Health
• Addiction Medicine
• Health Services Research

Background:

• Opioid use disorder (OUD) is a significant public health crisis.
• Emergency departments (EDs) are critical points for intervention.
• Low-threshold buprenorphine access can reduce OUD-related harms.

Purpose of the Study:

• To evaluate the scale-up of the CA Bridge program.
• To assess the implementation of buprenorphine, patient navigation, and harm reduction in California EDs.
• To report on patient reach and services provided.

Main Methods:

• The CA Bridge program provided funding and technical assistance to acute care hospitals in California.
• Data were collected from participating hospitals between April 2019 and June 2023.
• Key metrics included hospital participation, patient navigation encounters, and buprenorphine administrations.

Main Results:

• 268 (81.0%) of 331 acute care hospitals received CA Bridge support.
• Patient navigation services were provided during 279,025 encounters.
• Buprenorphine was administered during 89,549 ED visits.

Conclusions:

• The CA Bridge initiative effectively scaled low-threshold buprenorphine access and harm reduction services across diverse California ED settings.
• The program demonstrated significant reach, engaging a large number of patients and providing critical interventions.
• These findings support the expansion of similar ED-based models for OUD treatment.