The National Institute on Drug Abuse (NIDA) https://www.drugabuse.gov within NIH has information available for clinicians interested in how and when to initiate buprenorphine treatment in emergency departments. Buprenorphine is one of several medicines available for use in many emergency departments to treat Opioid Use Disorders (OUD).
Emergency Department (ED) clinicians face unique challenges when faced with patients suffering from opioid overdoses or other effects of OUD. They can often reverse overdoses using the medication naloxone, however, the medication alone does not treat the addiction itself. This makes the emergency setting an ideal place for clinicians to begin conversations on treatments with patients, however, there have been few tools available to guide clinicians.
NIDA has funded research on how initiate medication for OUD in the emergency setting. The result has been the development of a new comprehensive set of tools which includes information on best practices as well as case-based videos to help ED clinicians use effective strategies and conversation tips to treat OUDs.
The tools and resources now available include:
- A step-by-step buprenorphine integration pathway and treatment algorithm to assess opioid type and last use. Details are provided on how to assess, treat, discharge, and refer patients to a local treatment center if necessary
- Five case study videos showcase strategies to motivate patients towards ED-initiated buprenorphine, including a video on seeking treatment for OUDs, harm reduction, intervention, and treatment
- Discharge instructions including a guide for patients beginning buprenorphine at home
- Tools and assessments such as the Clinical Opioid Withdrawal Scale (COWS) used to determine the stage and severity of opioid withdrawal
- Questions for emergency clinicians to ask to be able to identify the OUD.
- Resources for providers that includes a handout on words to use when discussing OUDs, and discussions on opioid use studies from clinical trials.
- “Heroes in Practice” videos highlighting emergency physicians who have partnered with state entities to develop life-saving and innovative strategies for OUD treatment in EDs
The videos were funded by Aetna https://www.aetna.com, with all the research content featured in the videos developed by clinicians from Yale University https://www.yale.edu who have expertise in ED settings. Grant funding was provided by NIDA along with contract support from NIDA’s Clinical Trials Network.