This statewide program in California provides access to medications for opioid use disorder in the emergency departments of 53 hospitals and links to treatment
Recognizing that the emergency department is a potential vital touchpoint for initiating evidence-based interventions for opioid use disorder (OUD), the California Bridge Program is a partnership with the California Poison Control System and the California Hub and Spoke System to provide 24-7 emergency access to initiation of buprenorphine treatment for OUD in all California communities.
The program is built on three pillars:
- Treatment: Medications for opioid use disorder (e.g. buprenorphine) are accessible in the emergency department and in all other hospital departments. Treatment is provided rapidly in response to patient needs, not contingent on laboratory screening results, insurance status, commitment to treatment, or abstinence from all substances. Providers use a harm reduction approach and put patient needs at the center of the path to treatment
- Culture: Hospital culture is welcoming and does not stigmatize substance use, making disclosure of substance use inviting. There is a focus on using destigmatizing language.
- Connection: Linkage to ongoing care involves active support and follow up with patients. There is an arrangement with at least one community provider to accept referrals within 72 hours after buprenorphine is initiated in the emergency department.
Publications addressing initiation of buprenorphine in the emergency department can be found at this link. The program also offers a website that guides clinicians on how to implement a bridge clinic, including clinical protocols, best practices, and toolkits.
How this program finances the delivery of this intervention is highlighted in this blog.
This program reported a sharp statewide decrease in its efforts to expand access to buprenorphine as a result of the COVID-19 pandemic.