The Impact of Legislation and Implementation of an Emergency Department Medications for Opioid Use Disorder program on Buprenorphine Administration

The emergency department (ED) plays a critical role in addressing a wide range of healthcare needs and can be the first point of contact for individuals with opioid use disorder (OUD). Buprenorphine, a partial opioid agonist, is a medication that helps treat OUD. On January 12, 2023, federal changes removed a major barrier, allowing all clinicians to prescribe buprenorphine. Later in 2023, a Medications for Opioid Use Disorder (MOUD) program was implemented in a high-volume free-standing ED. We aimed to review the impact of these changes on buprenorphine administration. We conducted a retrospective chart review of buprenorphine administration and ICD codes from October 2021 to October 2024 in a high-volume ED. We included cases where buprenorphine was administered or an OUD-related ICD-10 code was present, and excluded cases where neither condition was met. During the 3-year period, 225,000 unique ED encounters were queried. From October 2021 to October 2022, 2 patients received buprenorphine and 46 OUD-related ICD-10 codes were noted (0.043 admin/OUD code). From October 2022 to October 2023, 18 patients received buprenorphine and 43 OUD-related ICD-10 codes appeared (0.419 admin/OUD code). From October 2023 to October 2024, 36 patients received buprenorphine and 36 OUD-related ICD-10 codes appeared (1.000 admin/OUD code). The increase in buprenorphine administration from 2022 to 2023 and 2023 to 2024 was statistically significant (p<0.001). In conclusion, both legislative changes and the ED MOUD program significantly increased buprenorphine administration, improving OUD treatment in the community ED.