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{
    "pk": 13407,
    "title": "Beyond Buprenorphine: Models of Follow-up Care for Patients with Opioid Use Disorder in the ED",
    "subtitle": null,
    "abstract": "Recent evidence shows that emergency physicians (EP) can help patients obtain evidence-based treatment for Opioid Use Disorder by starting medication for addiction treatment (MAT) directly in the Emergency Department (ED). Many EDs struggle to provide options for maintenance treatment once patients are discharged from the ED. Health systems around the country are in need of a care delivery structure to link ED patients with OUD to care following initiation of buprenorphine. This paper reviews the three most common approaches to form effective partnerships between EDs and primary care/addiction medicine services: the Project Alcohol and Substance Abuse Services and Referral to Treatment (ASSERT) model, Bridge model, and ED-Bridge model.\nThe ASSERT Model is characterized by peer educators or community workers in the ED directly referring patients suffering from OUD in the ED to local addiction treatment services. The Bridge model encourages prescribing physicians in an ED to screen patients for OUD, provide a short-term prescription for buprenorphine, and then refer the patient directly to an outpatient Bridge Clinic that is co-located in the same hospital but is a separate from the ED. This Bridge Clinic is staffed by addiction trained physicians and mid-level clinicians. The ED-Bridge model employs physicians trained in both emergency medicine and addiction medicine to serve within the ED as well as in the follow up addiction clinic.\nDistinct from the Bridge Clinic model above, EPs in the ED-Bridge model are both able to screen at-risk patients in the ED, often starting treatment, and to longitudinally follow patients in a regularly scheduled addiction clinic. This paper provides examples of these three models as well as implementation and logistical details to support a health system to better address OUD in their communities.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Social EM, OUD, MAT"
        }
    ],
    "section": "Behavioral Health",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/3hj8w038",
    "frozenauthors": [
        {
            "first_name": "Alister",
            "middle_name": "",
            "last_name": "Martin",
            "name_suffix": "",
            "institution": "Massachusetts General Hospital and Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Kelley",
            "middle_name": "",
            "last_name": "Butler",
            "name_suffix": "",
            "institution": "University of California, Irvine, School of Medicine, Irvine, California",
            "department": "None"
        },
        {
            "first_name": "Tyler",
            "middle_name": "",
            "last_name": "Chavez",
            "name_suffix": "",
            "institution": "Harvard Medical School, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Andrew",
            "middle_name": "",
            "last_name": "Herring",
            "name_suffix": "",
            "institution": "Highland Hospital-Alameda Health System, Department of Emergency Medicine, Oakland, California",
            "department": "None"
        },
        {
            "first_name": "Sarah",
            "middle_name": "",
            "last_name": "Wakeman",
            "name_suffix": "",
            "institution": "Massachusetts General Hospital, Department of Medicine, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Bryan",
            "middle_name": "D.",
            "last_name": "Hayes",
            "name_suffix": "",
            "institution": "Massachusetts General Hospital and Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Ali",
            "middle_name": "",
            "last_name": "Raja",
            "name_suffix": "",
            "institution": "Massachusetts General Hospital and Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts",
            "department": "None"
        }
    ],
    "date_submitted": "2019-12-06T07:35:34Z",
    "date_accepted": "2019-12-06T07:35:34Z",
    "date_published": "2020-11-02T18:23:12Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/13407/galley/7040/download/"
        }
    ]
}