Providing Buprenorphine in the Emergency Department


The local Emergency Department (ED) is continually calling the Main Street Recovery Center for assistance with overdose patients and currently provides referrals to the Center without any coordination of services. Main Street Recovery wanted to directly address this issue, as did the local ED. The ED first discussed the option of having a peer recovery specialist or even a therapist located at certain times in the ED; however, Main Street and the ED agreed this was too labor intensive. Instead, ED and Main Street decided to have the ED induct eligible patients wanting to begin Suboxone therapy and then provide three-day Suboxone starter kits.

To make this possible, Main Street trained ED staff on how to:

  • Reduce stigma,
  • Assess for OUDs,
  • Assess for Suboxone eligibility, and
  • Have conversations with patients about Suboxone care and use.

Once a patient is given the first dose and a three-day Suboxone “booster pack,” the patient is given a referral to Main Street and all paperwork is sent to Main Street.

Mutually Beneficial Outcomes of Braided Strategy

  • ED has a strategy of how to triage patients who present in opioid withdrawal—a strategy they feel reduces return ED visits and even saves lives.
  • The Recovery Center appreciates the public health benefit and the new patients that are referred from the ED. These patients often have insurance, are adherent to their regimen, and increase treatment group census. Main Street feels this is a great example of how a braided strategy can benefit the patient, the service provider, and the community!
  • The program has experienced a 92% follow-up rate for referred patients.