Emergency Department-Initiated Buprenorphine Validation Network Trial

Who can take part

• Be 18 years or older
• Treated in the ED during study screening hours
• Meet DSM-5 (Diagnostic and Statistical Manual) diagnostic criteria for moderate to severe OUD
• Have a COWS score of > or equal to 4
• Have a urine toxicology test that is positive for opioids (opiates, oxycodone, buprenorphine). Patients with urines that are only positive for fentanyl will be eligible if their clinical history and physical exam are consistent with opioid use and they meet DSM-5 criteria for moderate to severe OUD
• Able to speak English sufficiently to understand the study the study procedures and provide written informed consent to participate in the study. (Exception may be made if sites with large population of Spanish speaking patients are accepted for participation in the study and study materials are translated into Spanish. Translated study materials will be reviewed and approved by the Institutional Review Board) IRB of record prior to use.)
• Be 18 years or older
• Treated in the ED during study screening hours
• Meet DSM-5 diagnostic criteria for moderate to severe opioid use disorder
• Have a COWS <8
• Have a urine toxicology test that is positive for opioids (opiates, oxycodone, or buprenorphine). Patients with urines that are only positive for fentanyl on the point of care test strip will be eligible if their clinical history and physical exam are consistent with opioid use and they meet DSM-5 criteria for moderate to severe OUD
• Be able to speak English sufficiently to understand the study procedures and provide written informed consent to participate in the study

Who cannot take part

• Opioid administration (excluding BUP) at the index ED visit, prior to enrollment, and COWS remains < 8 during ED stay
• Be currently (anytime within the past 14 days) enrolled in formal addiction treatment, including by court order. Patients enrolled in formal addiction who are not receiving MOUD are eligible
• Have prior enrollment in the current study component; Ancillary Component:
• Have a medical or psychiatric condition that requires hospitalization at the index ED visit, prior to enrollment
• Be currently (anytime within the past 7 days) enrolled in formal addiction treatment, including by court order. Patients enrolled in formal addiction treatment but are not receiving MOUD are eligible
• Have prior enrollment in the current study
• Have a medical or psychiatric condition that requires hospitalization
• Require continued prescription opioids for a pain condition
• Require continued prescription opioids for a pain condition
• Have urine toxicology test that is positive for methadone
• Be pregnant as determined by human chorionic gonadotropin (hCG) testing at the index ED visit
• Be actively suicidal or severely cognitively impaired precluding informed consent
• Present from an extended care facility (e.g., skilled nursing facility)
• Be a prisoner or in police custody at the time of index ED visit
• Be unable to provide reliable locator information including 2 contact numbers in addition to their own
• Be unwilling to follow study procedures (e.g., unwilling to provide permission to contact referral provider/program or unavailable for the follow-up assessments)
• Have a urine toxicology test that is positive for methadone
• Be pregnant as determined by human chorionic gonadotropin (hCG) testing at the index ED visit
• Be actively suicidal or severely cognitively impaired precluding informed consent
• Present from an extended care facility (e.g., skilled nursing facility)
• Be a prisoner or in police custody at the time of index ED visit
• Be unable to provide reliable locator information including 2 contact numbers in addition to their own
• Be unwilling to follow study procedures (e.g., unwilling to provide permission to answer daily assessments until day 7)

Other criteria

• RCT Component: