Treatment of Opioid Use Disorder Across a National Emergency Department Practice Improvement Network

This study aimed to assess practices surrounding opioid use disorder (OUD), specifically provision of naloxone and medication for OUD (MOUD), in a large sample of emergency departments (EDs) participating in a quality improvement initiative.

Data were obtained from EDs participating in the American College of Emergency Physicians' Emergency Quality Network substance use disorder program, a national practice-based quality improvement initiative. ED sites abstracted data elements from a random sample of discharged visits with diagnosis codes for opioid overdose or OUD. Data were reported in May and October 2023 for visits that occurred up to 6 months prior to the reporting period. The percentages of visits for which naloxone was prescribed or dispensed and MOUD was administered or prescribed were determined.

There were 6,749 included visits for overdose or OUD reported from 300 unique EDs. Naloxone was either dispensed or prescribed in 1,874 (27.8%) of visits. There were 752 visits (11.1%) in which it was reported that the patient was already taking MOUD. Excluding those visits, MOUD was either administered in the ED or prescribed at discharge 438 times, representing 7.3% of potentially eligible visits.

In this large sample of visits for OUD and overdose, just over a quarter of patients with visits related to opioids were prescribed or dispensed naloxone, and administration or prescription of MOUD to patients not already on it was also low. These findings indicate opportunity for improvement in ED OUD care.