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. 2020 May;38(5):975-978.
doi: 10.1016/j.ajem.2020.02.011. Epub 2020 Feb 12.

Rates of substance use disorder treatment seeking visits after emergency department-initiated buprenorphine

Lindsey K Jennings  1 , Carolyn Bogan  2 , Jenna J McCauley  3 , Angela Moreland  4 , Suzanne Lane  5 , Ralph Ward  6 , Karen J Hartwell  7 , Louise Haynes  8 , Kathleen T Brady  9
Affiliations

Rates of substance use disorder treatment seeking visits after emergency department-initiated buprenorphine

Lindsey K Jennings et al. Am J Emerg Med. 2020 May.

Abstract

Background: Emergency department-initiated buprenorphine (EDIB) programs have been shown to improve treatment outcomes for patients with opioid use disorders (OUD); however, little is known about how EDIB implementation impacts the patient census at participating hospitals.

Objectives: To determine if implementation of an EDIB program was associated with changes in the number of patients presenting to the ED seeking treatment for substance use disorder (SUD).

Methods: We conducted a retrospective evaluation at a single academic ED that began offering EDIB in December 2017. Data span the period of December 2016 to April 2019, All ED visits with a chief complaint of addiction problem, detoxification, drug/alcohol assessment, drug problem, or withdrawal charted by nursing at the time of triage were eligible for inclusion. Charts were reviewed to determine: (1) treatment status and (2) substance(s) for which the patient was seeking treatment. An interrupted time series analysis was used to compare the pre- and post-EDIB rates for all-substance, as well as opioid-specific, treatment-seeking visits.

Results: For all-substance visits, the predicted level change in the treatment-seeking rate after EDIB was implemented was positive but not significant (0.000497, p = 0.53); the trend change after EDIB was also not significant (-0.00004, p = 0.73). For visits involving opioids, the predicted level change was (0.000638, p = 0.21); and the trend change was (0.000047, p = 0.49).

Conclusion: Implementation of an EDIB program was not associated with increased rates of presentation by patients requesting treatment for a substance use disorder in the participating ED setting.

Keywords: Access to care; Buprenorphine; Emergency medicine; Health care utilization; Opioid addiction; Opioid use disorder.

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Conflict of interest statement

Declaration of competing interest None.

Figures

Fig. 1.
Fig. 1.
Rates of monthly treatment-seeking visits for all substances (red points) and opioids (green points) with estimated interrupted time series models overlaid (solid lines).
See this image and copyright information in PMC

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