You are invited to join WSHA members in a learning cohort to facilitate improved treatment and outcomes for opioid use disorder (OUD) in the emergency department (ED), including adoption of OUD screening, buprenorphine initiation and rapid referral to long-term medication assisted therapy (MAT) providers.
OUD is recognized as a chronic condition requiring evidence-based MAT. EDs–often the only source of care for vulnerable patients with addiction—are improving access to buprenorphine and achieving results. The American College of Emergency Physicians (ACEP) aims for the majority of Washington Emergency Departments (EDs) to implement buprenorphine protocols by 2020.
The learning cohort will help hospitals achieve these aims through training on:
- Initiation of MAT in the ED (facilitating home induction when appropriate)
- Timely linkage to community-based MAT providers (rapid referral)
- Tracking to determine patient engagement
- Prescribing or dispensing take-home naloxone
WSHA will provide onsite implementation coaching, national expert guidance and bootcamp learning sessions to accelerate the work outlined above. With the commitment of leadership at your facility, multi-disciplinary teams will be asked to participate in in-person and webinar events. Teams may include CMOs, ED directors, CNOs, frontline ED nurse staff, social workers, pharmacists, behavioral health partners and non-clinical staff (patient advocates/peers) as appropriate.
We look forward to advancing this important work to reduce incidence of opioid overdose, mortality and achieve long-term retention in treatment programs! If you have questions or would like to participate, please contact Abby Berube (firstname.lastname@example.org) and Trish Anderson (email@example.com).
411 on ED MAT
Q: Do ED providers need to be DEA-X waivered to administer buprenorphine?
A: No. Under the “three-day rule” any opioid (including all formulations of buprenorphine) can be administered (not prescribed) in the ED for the treatment of acute withdrawal without a DEA “X” waiver, for no more than three consecutive days (72 hours).
Q: Is the ED the right place to start buprenorphine?
A: Yes. Almost any amount of participation in opioid agonist MAT likely adds a meaningful chance of improving patient survival. Buprenorphine can be initiated in the ED without complex psychosocial intake evaluation if resources are unavailable. Isolated buprenorphine MAT can be an important stand-alone harm reduction intervention.
Q: How can I better understand MAT medications, like buprenorphine?
A: Several webinars and are freely available to provide guidance. Project SHOUT (Support for Hospital Opioid Use Treatment) is a statewide coalition, led by champions at the University of California, San Francisco (UCSF), and supported by California Health Care Foundation (CHCF). In early 2018, SHOUT concluded a series of seven webinars outlining details around the implementation of opioid agonist therapy in the hospital setting including inpatient, OB, postoperative, and ED. The content is available on the SHOUT website: https://www.projectshout.org/webinars/