high volume EDs (81%). The majority saw patients presenting with OUD at least 1-5 times a week (43%) or more than 6 times per week (32%). Over half (54.6%) of the participants felt dissatisfied with the care their patients receive for OUDs in the ED. The most commonly reported interventions for patients with OUD included: provision of a take-home naloxone (54.1%), referral to a methadone/buprenorphine clinic (60.7%), referral to an addiction clinic (73.2%), and/ or instructions to see their family physician (74.3%). Most physicians never or rarely provided buprenorphine in the ED (74%) or via outpatient script (78%). Most (89%) never or rarely provided a prescription for other medications to prevent withdrawal symptoms. Physicians identified pre-printed order sets (91%), phone (92%) or on-site (88%) access to addiction specialists, on-site case managers (93%), and rapid access to addictions clinics (73%) as useful supports. Respondents identified written protocols as the most useful educational tool, followed by in-person presentations (75%) and brief online learning modules (75%). Conclusion: Clinical guidelines now strongly recommend buprenorphine as first line treatment for OUD, and ED-initiated and ED-prescribed buprenorphine have been found to be both feasible and effective. However, buprenorphine for OUD is currently underutilized in Canadian EDs, and only half of physicians surveyed routinely offer take-home naloxone. The reasons for this are likely multifactorial and systemic, and naloxone and buprenorphine may not always be available in EDs. Uptake of evidence-based recommendations may work to improve ED provider satisfaction in caring for patients with OUD. We will seek options to rapidly disseminate the simple interventions identified in this study, including pre-printed order sets and protocols.