Emergency Care for the Opioid Epidemic: Hospitals Step Up to Offer Buprenorphine in the ED
September 29, 2017
Both overdose deaths and opioid-related emergency visits are a critical problem for California’s emergency departments (EDs). However, there has been little guidance on what EDs should do with patients who present with signs and symptoms of opioid addiction — other than just saying no to a prescription request.
CHCF is sponsoring pain management and addiction medicine expert Andrew Herring, MD, from Highland Hospital-Alameda Health system to work with eight hospitals across California in 2017-18. These hospitals are starting programs to provide buprenorphine in the ED with close follow-up arranged in an outpatient setting.
Urban pilot sites
Alameda County — Highland Hospital’s emergency department working with Highland Hospital’s pain clinic, in the ED Bridge (ED MAT) program
San Francisco County — Zuckerberg San Francisco General Hospital working with San Francisco Health Network’s OBIC (office-based buprenorphine induction clinic)
San Francisco County — St. Mary’s Medical Center working with San Francisco Health Network’s OBIC
San Francisco County — St. Francis Memorial Hospital working with San Francisco Health Network’s OBIC
Rural pilot sites
El Dorado County — Marshall Medical Center working with El Dorado Community Health Center
Tuolumne County — Adventist Health Sonora working with Forest Road Health & Wellness Center
Humboldt County — St. Joseph Hospital Eureka working with Open Door Community Health Center
Rural County — to be announced after launch in late October 2017
This project follows a convening of emergency physicians, addiction specialists, behavioral health providers, and policy experts in the spring of 2016 to examine current models of ED addiction treatment and to discuss what it would take to spread these models in California. The meeting focused mostly on the use of buprenorphine in opioid use disorder and injectable naltrexone for alcoholism, globally referred to here as medication-assisted treatment (MAT).
Also available as a Document Download is a detailed outline of clinical protocols for MAT of opioid addiction in EDs, written by Dr. Herring. This document is intended to serve as a resource for EDs across California.