Studies reveal ER opioid treatment expansion saves lives

Patients in need of treatment for opioid use disorder can now find help at the emergency department of Alameda Health System's (AHS) Wilma Chan Highland Hospital Campus in Oakland. Emergency physicians and substance use navigators from the AHS Bridge Clinic are providing low-barrier access to care that begins simply by visiting the emergency room. This evidence-based approach has been successfully implemented in emergency departments across California, according to recent research.

The AHS Bridge Clinic is a partner of CA Bridge, a statewide initiative by the Public Health Institute's Bridge Center, which was established in 2018 by a group of emergency physicians. The initiative aims to enhance emergency care for opioid use disorder with three main components: easy access to buprenorphine, a medication that alleviates cravings and withdrawal symptoms; patient navigation to outpatient care; and harm reduction strategies.

Elizabeth Keating, MPA, clinical program director at CA Bridge, noted, "AHS was among the first health systems in California to adopt medication-assisted treatment for patients with opioid use disorder. Their commitment has served as an inspiration and a model for other hospitals across the state."

A recent study, co-authored by CA Bridge co-founder and AHS chief of addiction medicine Dr. Andrew Herring, revealed that over 80 percent of California hospitals have adopted the CA Bridge model and met data-reporting requirements between April 2019 and June 2023. The rapid expansion of CA Bridge in emergency departments suggests that this model can significantly increase opioid use disorder treatment and has the potential for nationwide implementation.

"The emergency room is often the first point of contact for many of our most vulnerable patients, particularly the uninsured," said Dr. Herring. "Expanding addiction treatment within emergency departments removes many barriers that people with opioid use disorder face. The growth of this strategy over the past four years shows its effectiveness, and we hope it will be adopted nationally."

Another study, published on July 8, supports the growing body of research on the effectiveness of buprenorphine for treating opioid use disorder. It indicates that patients can begin taking buprenorphine earlier in the withdrawal process than previously thought. An extended-release formulation that provides treatment for seven days was found to be acceptable, well-tolerated, and safe for individuals in early withdrawal with minimal symptoms. The findings suggest that up to 50 percent more patients could receive critical care if buprenorphine were offered sooner.

"The opioid crisis is devastating our communities and we see its impact in our hospitals daily," said AHS CEO James Jackson. "As a safety-net health system serving all of Alameda County, we have a moral duty to act. I am proud of The AHS Bridge Clinic's low-barrier model of care, the vital research it supports, and its involvement with the broader CA Bridge initiatives to scale evidence-based treatment to address the crisis."

AHS provides same-day appointments Monday through Friday at The AHS Bridge Clinic, located on The Wilma Chan Highland Hospital Campus in Oakland, CA. Opioid use disorder treatment, including buprenorphine, is accessible 24/7 in the emergency department.

Alameda Health System (AHS) is a prominent public, integrated health care provider known for its patient and family-centered care. AHS offers comprehensive medical treatment, health promotion, and disease prevention across its network of hospitals, clinics, and health services. The system includes three acute care hospitals, a psychiatric hospital, four ambulatory care wellness centers, five post-acute facilities, and the only adult Level 1 Trauma Center and psychiatric emergency department in Alameda County. AHS is dedicated to promoting wellness and optimizing community health through its mission of caring, healing, teaching, and serving all.

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