Increasing Emergency Department Patient Navigation And Buprenorphine Use: A Model For Low-Barrier Treatment

Area of Science:

• Public Health
• Emergency Medicine
• Addiction Medicine

Background:

• Emergency departments (EDs) encounter many individuals with opioid use disorder (OUD).
• Most health systems lack adequate resources for ED-based OUD care.
• The CA Bridge program promotes low-threshold, ED-initiated OUD treatment.

Purpose of the Study:

• To assess the implementation and impact of the CA Bridge program in California EDs.
• To evaluate statewide buprenorphine prescribing trends in EDs.
• To analyze patient navigator encounters and buprenorphine treatment rates.

Main Methods:

• Analysis of CA Bridge grant reporting data (July 2022-December 2023).
• Examination of California controlled substances prescribing data for 2022.
• Comparison of treatment rates between public and private hospitals.

Main Results:

• Over 165,000 patient navigator encounters and 44,000 buprenorphine treatments occurred at CA Bridge hospitals.
• Public hospitals demonstrated over 50% higher rates for patient navigation and buprenorphine treatment.
• In 2022, 1,737 California emergency clinicians prescribed buprenorphine 6,382 times, with 36% receiving a subsequent prescription within 40 days.

Conclusions:

• EDs are vital settings for reaching individuals with OUD.
• The CA Bridge program facilitates high buprenorphine uptake in emergency settings.
• Implementation of ED-based OUD treatment models shows promising results.