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. 2025 Jun 3;6(4):100192.
doi: 10.1016/j.acepjo.2025.100192. eCollection 2025 Aug.

Emergency Department-Based Medication for Opioid Use Disorder: A 5-Year Experience

David C Seaberg  1 , Jamie McKinnon  2 , Lyn Haselton  1 , Quentin Reuter  1 , Jason Kolb  1 , Suman Vellanki  2 , J Chika Morah  1 , Jonathan Oskvarek  1 , Nicholas Jouriles  1
Affiliations

Emergency Department-Based Medication for Opioid Use Disorder: A 5-Year Experience

David C Seaberg et al. J Am Coll Emerg Physicians Open. .

Abstract

Introduction: Medication for opioid use disorder (MOUD) programs are effective in treating opioid use disorder (OUD). Successful programs are resource-intensive. We describe our 5-year emergency department (ED)-based MOUD program results.

Methods: Our MOUD program uses Addiction Care Coordinators to coordinate care for OUD patients presenting to our ED. Peer recovery specialists provide counseling. Our MOUD program is available daily at our 2 hospitals. In 2021, we expanded our MOUD program to our 2 free-standing EDs using a telemedicine platform. Outcomes included the number of patients inducted over 5 years (2019-2023), the number inducted through telehealth, and the retention rate in the MOUD outpatient program at 1 and 6 months.

Results: All 373,797 ED patients were screened for OUD over the 5 years, and 1072 (2.8%) were inducted into the MOUD program. A total of 53 patients (4.9%) were inducted through telemedicine. The number of patients inducted declined yearly; however, inpatient admissions for OUD declined less. The overall retention rate was 36.5% at 1 month and 28.8% at 6 months and then declined yearly. According to state data, the number of opioid and buprenorphine prescriptions also went down during this 5-year period.

Discussion: ED-based MOUD programs expand access to treatment for patients with OUD. Patients' use of the ED-based MOUD program has declined each year, and retention rates have fallen. Several factors could be involved, such as increased strength of fentanyl, worsening withdrawal symptoms, increased inpatient admissions, and expansion of MOUD to community sites. Cost-effective strategies are needed to continue these programs.

Keywords: MOUD; medication for opioid use disorder; opioid use disorder; telehealth.

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Conflict of interest statement

All authors have affirmed they have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
OUD patients admitted versus ED-based MOUD. ED, emergency department; MOUD, medication for opioid use disorder; OUD, opioid use disorder.
Figure 2
Figure 2
ED-based MOUD retention rates with 95% CIs. ED, emergency department; MOUD, medication for opioid use disorder.
Figure 3
Figure 3
Opioid prescriptions written per 100,000 population in 5 referral county areas.
Figure 4
Figure 4
Buprenorphine prescriptions written per 100,000 population in 5 county referral areas.
Figure 5
Figure 5
Opioid overdose deaths per 100,000 population in 5 county referral areas.
See this image and copyright information in PMC

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