A more intensive intervention for opioid-dependent patients in a hospital emergency room, including the initiation of treatment with buprenorphine, was found to reduce self-reported opioid use and decrease the need for subsequent inpatient treatment in a study of 329 patients.
Published April 29 in the Journal of the American Medical Association, the study compared three interventions for opioid-dependent individuals visiting the emergency department of an urban teaching hospital: screening and referral to treatment; screening, brief intervention and a facilitated referral to a community-based treatment provider; and screening, brief intervention, treatment with a buprenorphine/naloxone combination, and referral to a primary care physician for 10-week follow-up.
The researchers in the National Institute on Drug Abuse (NIDA)-funded study found increased treatment engagement in the group that had received medication at the ER, with 78% of that group being engaged in addiction treatment 30 days after study entry (compared with rates of 37% and 45% in the other two patient groups). In addition, the buprenorphine group reduced the number of opioid-using days to a greater extent than the other two groups, and used an inpatient level of addiction treatment services to a lesser degree than the other patients.
However, the more intensive intervention was not found to have a significant effect on rates of negative urine tests for opioids, the researchers reported.