The use of buprenorphine to-go packs in the emergency department

• Published in: The American journal of emergency medicine Vol. 77; pp. 154 - 157
• Main Authors: Zimmerman, David E., Johnson, Benjamin, Kearns, Amanda, Metro, Heather, Robb, Abigail, Nemecek, Branden D., Montepara, Courtney A., Covvey, Jordan R., Lynch, Michael J.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2024; Elsevier Limited
• Subjects: Adult; Buprenorphine; Buprenorphine - therapeutic use; Drug abuse; Drug addiction; Drug overdose; Drug withdrawal; Electronic health records; Emergency department; Emergency medical care; Emergency medical services; Emergency Service, Hospital; Humans; Length of stay; Male; Medical records; Narcotic Antagonists - therapeutic use; Narcotics; Opiate Substitution Treatment; Opioid use disorder; Opioid-Related Disorders - drug therapy; Opioids; Overdose; Patients; Pharmacy; United States; United States; United States > US; PDMP; Emergency department; Buprenorphine; MOUD; COWS; Opioid use disorder; ED; OUD
• ISSN: 0735-6757; 1532-8171; 1532-8171
• DOI: 10.1016/j.ajem.2023.12.025

Buprenorphine is an effective treatment for opioid use disorder (OUD). Patients in the emergency department (ED) can be initiated or continued on buprenorphine as a bridge to follow-up in the outpatient setting, but gaps in care may arise. The objective was to evaluate the impact of buprenorphine to-go packs as a continuing treatment option for patients presenting to the ED with OUD across a health system. Adult patients discharged with a buprenorphine to-go pack from one of ten EDs within a major health system were included. The primary outcomes assessed within 30 days of ED discharge were: (1) return to a health system ED, and (2) fill history of buprenorphine in the state prescription drug monitoring program database. Data was analyzed using descriptive statistics in Microsoft Excel (Redmond, WA). A total of 124 patients received buprenorphine to-go packs. The sample was primarily male (79; 63.7%), white (89; 71.8%), on Medicaid (79; 63.7%), and had a mean age of 40.9 years. A total of 43 patients (34.7%) were initiated on buprenorphine for the first time, while 81 (65.3%) had received buprenorphine (prescription or to-go) previously. At 30 days post-visit, 76 (61.3%) had filled buprenorphine prescriptions, and 40 (32.3%) returned to an ED within the health system for opioid withdrawal (17; 42.5%), non-OUD-related reasons (22; 55%), or overdose (1; 2.5%). The implementation of a system-wide buprenorphine to-go supply at ED discharge is a feasible option to provide continuity of care to patients with OUD.