New opioid treatment resources for emergency department clinicians

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The National Institute on Drug Abuse (NIDA) today announced the availability of informational resources for clinicians interested in initiating buprenorphine treatment in emergency department settings. Buprenorphine is one of several medicines available for use in many emergency departments to treat opioid use disorders (OUD). The materials were developed by emergency department specialists at Yale University with grant support from NIDA, and contract support from NIDA’s Clinical Trials Network. NIDA is part of the National Institutes of Health.

Emergency department clinicians face unique challenges when faced with patients suffering from opioid overdoses or other effects of OUD. They can often reverse overdoses using the medication naloxone, however, that medication alone does not constitute treatment for the addiction itself. This makes the emergency setting an ideal place for clinicians to begin treatment conversations with patients, however, there have been few tools available to guide them. Since 2002, emergency clinicians have been able to administer buprenorphine to help patients manage opioid withdrawal symptoms, but the practice is still new in many emergency department settings.

NIDA has funded research into the initiation of medication for OUD in the emergency setting, with findings reflected in these new resources. This new comprehensive set of tools includes information on best practices as well as case-based videos to provide emergency department clinicians with effective strategies and conversation tips to treat people with opioid use disorders. These new informational resources, which specifically highlight buprenorphine treatment, are now provided as a courtesy on the NIDAMED web portal, and do not constitute official clinical guidelines or standards.  The NIDAMED web portal disseminates science-based resources to health professionals on the causes and consequences of drug use and addiction, and advances in pain management.

Highlights of the tools and resources now available include:

• Treatment Information, including a step-by-step buprenorphine integration pathway and treatment algorithm to assess for opioid type and last use. These steps include details on how to assess, treat, discharge and refer patients to a local treatment center, if necessary.
• *Five case study videos showcasing strategies to motivate patients towards emergency department-initiated buprenorphine, including seeking treatment for OUD, harm reduction, intervention and treatment.
• Discharge instructions, which includes a guide for patients beginning buprenorphine at home.
• Tools and assessments, including the Clinical Opioid Withdrawal Scale (COWS) (determines the stage and severity of opioid withdrawal) and questions for emergency clinicians to ask to help with the identification of an OUD.
• Provider resources, including a handout on words to use when discussing OUDs and ongoing opioid use studies from clinical trials.
• *Heroes in practice videos, highlighting emergency physicians around the country who have partnered with state entities to develop life-saving and innovative strategies for OUD treatment in emergency departments.
• Frequently asked questions

For a more comprehensive list of these new buprenorphine treatment resources for emergency department clinicians, go to: Initiating Buprenorphine Treatment in the Emergency Department.

For more information on medications to treat OUD, go to: Medications to Treat Opioid Use Disorder.

For more information on the NIDAMED initiative, go to: NIDAMED: Medical & Health Professionals

For more information, contact the NIDA press office at media@nida.nih.gov or 301-443-6245. Follow NIDA on Twitter and Facebook.