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New York MATTERS

A state-wide electronic referral program connects those with opioid use disorder to medication-assisted treatment

For those with opioid use disorder (OUD), immediate access to buprenorphine and follow-up treatment is critical to success in recovery. Started as an initiative to reduce opioid prescribing in emergency departments, the New York Medication for Addiction Treatment and Electronic Referrals (MATTERS) is now a state-wide electronic referral system and hospital network that facilitates rapid entry into treatment for those with substance use disorders. Hospitals and clinics in the MATTERS network are required to offer buprenorphine to individuals presenting with OUD. Referrals are expedited by a state electronic database of treatment options patients can choose among using a Wi-Fi tablet, and transportation to the clinic is provided. The program has recently expanded its network to include correctional facilities, OB/GYN and primary care practices, and first responders such as EMS, police, and firefighters.

In addition to free transportation to and from clinic for the first appointment, the program provides:

  • A voucher covering the cost of buprenorphine for 2 weeks
  • Support for harm reduction measures such as providing naloxone and fentanyl test strips
  • Instruction for patients on initiating buprenorphine treatment at home
  • Consultation for hospitals in caring for those presenting with OUD
  • Referrals for patients during virtual emergency room visits

A detailed description of the program's rationale, development, and implementation is here, and recent news about the program here.

 Immediate access to buprenorphine and rapid placement into treatment are critical when responding to the opioid overdose crisis.

Continuum of Care
Treatment
Harm Reduction
Type of Evidence
Peer-reviewed
Response Approach
Cautious Opioid Prescribing
Medications for Opioid Use Disorder
Post-overdose response
Peer-reviewed Article
Population characteristics and follow-up rates of a novel emergency buprenorphine initiation and referral program
Implementing a Novel Statewide Network to Support Emergency Department-initiated Buprenorphine Treatment
Emergency department interventions for opioid use disorder: A synthesis of emerging models
Related Resources
A Scalable, Automated Warm Handoff from the Emergency Department to Community Sites Offering Continued Medication for Opioid Use Disorder: Lessons Learned from the EMBED Trial Stakeholders
Hospitals’ Role in Addressing the Opioid Crisis: Buprenorphine in the Emergency Department
A Novel Social Work Approach to Emergency Department Buprenorphine Induction and Warm Hand-Off to Community Providers
Guidelines for Medication for Addiction Treatment for Opioid Use Disorder within the Emergency Department
Improving Access to Evidence-Based Medical Treatment for Opioid Use Disorder: Strategies to Address Key Barriers within the Treatment System
Emergency Discharge Protocols for Patients with Substance Use Disorders and Opioid Overdoses in Maryland’s Hospitals
The Washington State Hub and Spoke Model to Increase Access to Medication Treatment for Opioid Use Disorders
Factors that Influence Access to Medication-Assisted Treatment
Shatterproof Report on County Buprenorphine Access in the United States
Background-^0-Overview-Feb-2021-Update.pdf

Evidence of Program Effectiveness

"New York State’s Medication Treatment and Electronic Referrals network provides compelling evidence that ED-initiated buprenorphine as a public health approach to addressing the opioid epidemic can be expanded into a scalable intervention model, operating through a broad network of hospitals and community-based clinicians." Clemency et al., 2022

"These five programs (an academic medical center, two large urban hospitals, a rural community hospital, and a community-based program) successfully implemented ED-initiated MOUD. Often a champion with knowledge of OUD treatment and a reliable connection with outpatient treatment began the program. The approach to patient identification varied from universal screening to relying on patient self-identification. Substance use treatment navigators provide crucial services but can be difficult to pay for within current reimbursement frameworks. Barriers to implementation include lack of knowledge about treatment options and effectiveness, stigma, community treatment capacity limits, and health insurance and reimbursement policies. Facilitators of success include taking a patient-centered, low-barrier approach, having a passionate champion, a strong structure with health system support, and a relationship with community partners. Metrics for success vary across programs. Some programs are expanding to include treating the use of other substances such as alcohol and stimulants." Thomas et al., 2022