OAKLAND, Calif., March 13, 2025 (GLOBE NEWSWIRE) — Patients who struggle with opioid addiction and who are treated by California emergency department physicians are remarkably successful at achieving long-term engagement in treatment and recovery, according to an original investigation recently published in the Journal of the American Medical Association (JAMA).
Emergency physicians are rising to the challenges posed by the opioid epidemic and increasingly learning how to provide high-quality care to people with an opioid use disorder (OUD) — including prescribing buprenorphine. Buprenorphine is a highly effective medication that treats opioid cravings, related depression, and withdrawal symptoms. Buprenorphine is an inexpensive and safe treatment for OUD and that has been shown to immediately reduce the risk of overdose death.
The investigation, “Emergency Clinician Buprenorphine Initiation, Subsequent Prescriptions, and Continuous Prescriptions,” by Dr. Anette M. Dekker, Dr. David L. Schriger, Dr. Andrew A. Herring, and Dr. Elizabeth A. Samuels, examines the statewide impact of the largest buprenorphine expansion initiative ever conducted in U.S. emergency departments.
The initiative is led by CA Bridge, an organization co-founded by Dr. Herring, chief of addiction medicine at Alameda Health System (AHS), founder of The AHS Bridge Clinic in Oakland, California, and a leading advocate for expanding patient access to high-quality, evidence-based treatment for substance use disorders. It is based on an AHS pilot project in which emergency physicians from all over California work to improve emergency care for individuals with a substance use disorder. The program helps emergency departments implement the Bridge model of care, including three evidence-based elements: low barrier access to buprenorphine, harm reduction, and patient navigation to outpatient care.
“The emergency department successfully provides access to health care to the most vulnerable in society. The ED is central to our strategy for reaching opioid use disorder patients 24-7 with low-barrier access to effective treatments. Initiating buprenorphine treatment in the ED increases patients’ chance of survival and doubles the likelihood that they will remain in treatment 30 days later. What CA Bridge showed was that when you provide funding and training, emergency physicians are ready to prescribe buprenorphine, and patients do very well. The big question is: How do we fund and support health systems to sustain this work for the long haul?” said Dr. Herring.
The investigation found a 4.9% increase in buprenorphine prescribed by California emergency clinicians, following efforts to expand the CA Bridge program. Notably, one in three new emergency department buprenorphine initiation prescriptions was followed by a second prescription, demonstrating that introducing buprenorphine to patients can be a first step toward sustained substance use disorder treatment. Emergency physicians are not only prescribing buprenorphine more often but are also spreading the word about its efficacy; the annual number of emergency department buprenorphine prescribers increased from 78 in 2017 to 1,789 in 2022.
“Since launching CA Bridge in 2018, we have watched buprenorphine prescribing grow from the early adopters to the joiners to the standard of care for emergency clinicians,” said CA Bridge Clinical Program Director Elizabeth Keating. “As this research shows, clinicians have adopted this as common-sense care that improves patient outcomes and hospital culture.”
An editorial extolling the success of the expansion of the Bridge model, “State Investment in Emergency Department Buprenorphine Pays Off,” authored by Dr. Gail D’Onofrio, Dr. Jon B. Cole and Dr. Jeanmarie Perrone and published in JAMA alongside the investigation, asserts that “the study by Dekker et al provides substantial evidence that with adequate state investments, EDs can play a crucial role for patients with opioid addiction—being available as a safety net 24 hours a day, 365 days a year, and providing pivotal steps in the cascade of care. California provides a model and blueprint for other states to follow for both urban and rural areas as we continue to fight this epidemic. It is informative and exciting to see that emergency clinicians are playing an increasingly central role in the addiction medicine workforce.”
“Those who suffer from substance use disorder face far too many obstacles to evidence-based treatment,” said AHS CEO James Jackson. “The AHS Bridge Clinic has developed a model of care that successfully reduces barriers to treatment. It is also a hub of thought leadership in medication-assisted treatment. I’m proud that our addiction medicine team, led by Dr. Herring, is developing literature that advances the field of addiction medicine beyond the walls of our facilities, and is leading efforts to scale a model of care that is truly patient-centered.”
Provisional data from the Centers for Disease Control (CDC) indicate a decline in drug overdose-related deaths over the last year. Still, drug overdose remains the leading cause of death among Americans aged 18-44, and more than 5.5 million Americans live with opioid use disorder. It’s estimated that 87% of people with opioid addiction never receive medications such as buprenorphine, despite robust evidence that it saves lives.
About Alameda Health System
Alameda Health System (AHS) is a leading safety-net, 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, an affiliate acute care hospital, 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.
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CONTACT: Eleanor Ajala
Manager, Media and Communications
Alameda Health System
(510) 421-9222
[email protected]
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