Adaptive Treatment Strategies to Increase Long-Term Buprenorphine Use for Adults with Opioid Use Disorder in the Emergency Department

What this Trial Is About

Researchers are evaluating adaptive interventions to increase long-term use of buprenorphine in adults with probable opioid use disorder OUD who come to the emergency department ED. This trial uses a two-stage, sequential multiple assignment randomized design to develop the most effective approach. The study aims to compare different treatment strategies to see which helps maintain buprenorphine use longer and delays overdose, self-harm, or death. The trial includes several treatment options. Initially, participants receive either the CA Bridge Model with Substance Use Navigator SUN assisted treatment initiation and linkage to care or the same approach plus immediate telehealth connection to an outpatient provider SUNTeleBridge. Those who do not respond within 90 days are randomized to receive ongoing buprenorphine treatment by an ED-based interim treatment team ED-ITT alone or with added behavioral health support ED-ITTBHS for up to 3 months. Responders receive no further active intervention unless they return to the ED or report stopping buprenorphine. Participants will be monitored for buprenorphine prescription fills over 6 months and tracked for overdose, suicide, self-harm, or death events. Researchers will review prescription records, patient reports, and ED visits to assess treatment adherence and outcomes. The study involves regular follow-up and behavioral health assessments to evaluate the effectiveness of different adaptive treatment strategies over one year.

Adaptive Interventions for Emergency Department Patients With Opioid Use Disorder