A New Way Forward in the Emergency Department

Schwarz, Evan S.; Laes, Jo An R.; Wiegand, Timothy J.

doi:10.1007/s13181-019-00718-x

Cited by 3 publications

(2 citation statements)

References 25 publications

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“…This is reflected in the lack of treatment focus for OUD in the acute care setting. In addition, when patients are engaged in long‐term treatment, they are less likely to present to ED with other drug‐related presentations such as overdose, cellulitis or endocarditis 37,45 . Australian EDs are constrained by significant time pressures, so EDIB protocols need to be efficient and make best use of available resources.…”

Section: Discussionmentioning

confidence: 99%

“…In many tertiary hospitals in Australia there are addiction medicine consultant liason services that have the potential to facilitate ‘warm handovers’ and educate and support emergency physicians. Although there may be concern from clinicians that EDIB may increase presentations to already overcrowded EDs, this has not been reported in North America 45 . Novel community‐based approaches such as rapid‐access clinics could alleviate the wider demand for OAT.…”

Section: Discussionmentioning

confidence: 99%

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Review article: Rapid review of the emergency department‐initiated buprenorphine for opioid use disorder

Salter

Hutton

Cantwell

et al. 2020

Emerg Medicine Australasia

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Opioid-related harms have been increasing in Australia over the last 5 years. Patients with opioid use disorder are over-represented in ED presentations. Opioid agonist treatment is the most effective community-based treatment. Buprenorphine is considered the safest of these treatments to use in the ED setting. This rapid review investigated the effectiveness of initiating buprenorphine in the ED setting. Medline, Embase, Emcare, PSYCinfo, CINAHL and Cochrane Central Register of Controlled Trials databases were searched. Randomised and non-randomised studies published in peer-reviewed journals that involved the initiation of buprenorphine in the ED setting were considered eligible. The search revealed 350 articles of which 11 were included in the review; three articles representing two randomised controlled trials (RCTs) and eight observational studies. Data were extracted from included papers and risk of bias assessed on the RCTs. One well-conducted RCT showed that buprenorphine initiated in the ED does improve treatment engagement up to 2 months after an ED visit. Eight observational studies, one with a comparator group reported positive results for this intervention. There is strong evidence that clinicians should consider commencing buprenorphine in the ED for patients with opioid use disorder when combined with a direct and supported referral or 'warm handover' to community care. Further implementation studies and investigation of long-acting injectable buprenorphine treatment are required.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%