The Emergency Department as an Implementation Science Laboratory: Evidence Based Treatment for Opioid Use Disorder

Lauren Whiteside MD MS
Assistant Professor
Department of Emergency Medicine
University of Washington

ABSTRACT:
The Emergency Department (ED) is at the forefront of opioid public health crisis with increasing ED visits for overdose and opioid.  Additionally, deaths related to opioids are increasing despite work that is ongoing around harm reduction and access to treatment.  There is a growing body of evidence that patients with OUD initiated on buprenorphine in the ED are more likely to be engaged in substance use treatment at 30-days compared to patients who are referred to outpatient treatment only.  Additionally, there is an increasing evidence-base for other ED-based interventions such as take-home naloxone and care navigation to improve care transitions.

This talk will discuss some unique challenges related to implementation of evidence-based treatment in the ED.  Next, I will share results from a qualitative study of Emergency physicians highlighting the barriers and facilitators of ED-initiated buprenorphine using the Consolidated Framework for Implementation Science.  Lastly, I will describe a pilot pragmatic randomized clinical trial of a care coordination intervention called ‘Emergency Department Integrated Care’ or ED-LINC and discuss innovative ways to improve provision of evidence-based treatment for patients with OUD from the ED.