Recent studies show that expanding opioid use disorder treatment in emergency room settings saves lives

OAKLAND, Calif., Aug. 28, 2024 - Patients who need opioid use disorder treatment can find it 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 offering a model of low barrier access to care that starts by simply showing up to the emergency room. It's an evidence-based strategy that has been successfully scaled to emergency departments across California, according to new research.

The AHS Bridge Clinic is an affiliate of CA Bridge, a statewide initiative of the Public Health Institute's Bridge Center that was founded in 2018 by a team of emergency physicians to improve emergency care for individuals with opioid use disorder using a model of care with three core elements: (1) low barrier access to buprenorphine, a medication used for opioid use disorder that diminishes the symptoms of cravings and withdrawal, (2) patient navigation to outpatient care, and (3) harm reduction.

"AHS was one of the first health systems in California to embrace the promise of medication to help patients struggling with opioid use. They have served as an inspiration and a demonstration not only for the rest of the state's safety net hospitals but also for the overwhelming majority of hospitals in the state as they reached readiness to address patients presenting to the ED with substance use challenges," said Elizabeth Keating, MPA, clinical program director at CA Bridge.

A recent study authored by a team of researchers, including CA Bridge co-founder and AHS chief of addiction medicine Dr. Andrew Herring, found that more than 80 percent of California hospitals have adopted the CA Bridge model and completed data-reporting requirements between April 2019 and June 2023.

The rapid scale-up of CA Bridge in emergency departments across the state suggests that CA Bridge offers a promising implementation model that exponentially expands opioid use disorder treatment and could be scaled beyond California.

"The emergency room is the entry point to health care for many of our most vulnerable patients, especially the uninsured. And yet it's an underutilized resource in efforts to treat people with opioid use disorder," said Dr. Herring. "Expanding addiction treatment in emergency department settings removes many of the barriers to treatment that people with opioid use disorder encounter. The scale-up of this strategy over the last four years demonstrates that it's an effective model, and we hope it will be adopted nationally."

A second study, published on July 8, adds to a growing body of research examining the effectiveness of buprenorphine to treat opioid use disorder. It suggests that patients can safely take buprenorphine earlier in the withdrawal process than previously known.

A formulation of the medication that delivers extended treatment lasting seven days was found to be acceptable, well tolerated, and safe for people in early withdrawal with minimal to mild symptoms. The results indicate that up to 50 percent more patients could receive life-saving care if buprenorphine was offered to them sooner.

"The opioid crisis is crippling our communities, killing our neighbors, and we see the impact in our hospitals every day," said AHS CEO James Jackson. "As a safety-net health system that serves all in Alameda County, we have a moral imperative to act. I'm proud of The AHS Bridge Clinic's low barrier model of care, the important research it's helping to develop, and its engagement with broader CA Bridge initiatives to scale evidence-based treatment to the magnitude of the crisis."

AHS offers same-day appointments Monday-Friday at The AHS Bridge Clinic, located on The Wilma Chan Highland Hospital Campus in Oakland, CA. Access to opioid use disorder treatment including buprenorphine is available 24 hours a day, seven days a week, in the emergency department.

About Alameda Health System

Alameda Health System (AHS) is a leading public, integrated health care provider and medical training institution recognized for its world-class patient and family-centered care. AHS provides comprehensive medical treatment, health promotion and disease prevention throughout our integrated network of hospitals, clinics and health services. AHS 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 committed to promoting wellness and optimizing the health of the community through the mission of caring, healing, teaching and serving all. For more information, visit AlamedaHealthSystem.org.

CONTACT:
Eleanor Ajala
Manager, Media and Communications
Alameda Health System
(510) 421-9222
[email protected]

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