Description of Strategy
Typically policymakers have viewed emergency rooms as a place for those with opioid use disorders to obtain opioid prescriptions. However, recent scholarship has shown that the contribution of opioids to a community by emergency departments is quite low, accounting for approximately 1.5% of all opioid prescriptions within a community (Menchine et al., 2014). In fact, it is suggested that hospital emergency rooms which initiate medication-assisted treatment protocols using buprenorphine can efficiently address opioid use disorders (Busch, 2017). They are then better able to support patients with OUD by connecting them to treatment programs.
Wyoming does not have any statewide policies requiring OUD medication to be provided in emergency departments, although some emergency departments may do so on an individual basis.
Discussion of Effectiveness
Some research has shown that low doses of buprenorphine by emergency department clinicians can be effective helping patients manage their opioid use disorder (Berg et al., 2007). In one study, emergency department-initiated buprenorphine treatment resulted in a significant increase in the percentage of patients that took part in opioid use disorder treatment programs over a 30-day period (D’Onofrio et al., 2015).
Berg, M. L., Idrees, U, Ding, R., Nesbit, S. A., Liang, H. K., & McCarthy, M. L. (2007). Evaluation of the use of buprenorphine for opioid withdrawal in an emergency department. Drug and Alcohol Dependence, 86(2–3), 239–244.
Busch, S. H., Fiellin, D. A., Chawarski, M. C., Owens, P. H., Pantalon, M. V., Hawk, K., Bernstein, S. L., O’Connor, P. G., & D’Onofrio, G. (2017). Cost‐effectiveness of emergency department‐initiated treatment for opioid dependence. Addiction, 112: 2002– 2010.
D’Onofrio, G., O’Connor, P. G., Pantalon, M. V., Chawarski, M. C., Busch, S. H., Owens, P. H., Bernstein, S. L., & Fiellin, D. A. (2015). Emergency department–initiated buprenorphine/naloxone treatment for opioid dependence: a randomized clinical trial. JAMA: Journal of American Medical Association, 313(16), 1636–1644.
Menchine, M. D., Axeen, S., Plantmason, L., & Seabury, S. (2014). Strength and dose of opioids prescribed from US emergency departments compared to office practices: Implications for emergency department safe-prescribing guidelines. Annals of Emergency Medicine, 64(4), S1.