Breaking Barriers: Enhancing Buprenorphine Access Through Legislation and Programmatic Changes

Document Type

Conference Proceeding

Publication Date

5-13-2025

Publication Title

Acad Emerg Med

Keywords

buprenorphine, adult, conference abstract, controlled study, drug therapy, emergency department visit, emergency ward, female, health care system, human, ICD-10, law, major clinical study, male, medical record review, opioid use disorder, opioid withdrawal syndrome, retrospective study

Abstract

Background and Objectives: The emergency department (ED) is a critical part of the U.S. healthcare system, addressing urgent needs of diverse populations, including those with opioid use disorder (OUD). Buprenorphine is a key medication for managing OUD. A January 2023 federal legislation change removed barriers for clinicians to prescribe buprenorphine. In October 2023, a Medications for Opioid Use Disorder (MOUD) program was launched in a high-volume, free-standing ED. This study aims to assess the impact of these changes on buprenorphine administration. Methods: We conducted a retrospective chart review of buprenorphine administration and International Classification of Diseases (ICD) codes from October 2021 to October 2024 at a high-volume free-standing ED. Cases included if buprenorphine was administered during the ED visit or an OUD-related ICD-10 code was in the diagnosis. We excluded cases without buprenorphine administration or OUD-related ICD-10 codes. A sub-analysis was conducted to determine if buprenorphine administration was a continuation of a patient's medication or an induction for opioid withdrawal, with arrangements for ongoing medication and care beyond the ED visit. Results: We analyzed 225,000 unique ED encounters from October 2021 to October 2024. Between October 2021 and October 2022, there were 2 buprenorphine administrations and 46 encounters with an OUD-related ICD-10 code (0.043 admin/OUD), with one administration being an induction for opioid withdrawal. From October 2022 to October 2023, there were 18 administrations and 43 OUD-related encounters (0.419 admin/OUD), with four inductions. From October 2023 to October 2024, this increased to 35 buprenorphine administrations and 36 OUD-related encounters (0.972 admin/ OUD), with ten inductions. The increase in buprenorphine administration from October 2022 to October 2023 was statistically significant (OR 15.8, 95% CI 3.4-73.9, p < 0.001), as was the rise from October 2023 to October 2024 (OR 2.3, 95% CI 1.6-3.2, p < 0.001). Conclusion: There was a significant increase in buprenorphine administration following legislation that eased prescribing barriers. A further increase was noted post-initiation of the ED MOUD program. Both factors likely contributed to these increases. ED MOUD programs can enhance OUD treatment in community EDs.

Volume

32

Issue

S1

First Page

259

Find It @ Sladen

Share

COinS