Emergency Department Buprenorphine Treatment: A Toolkit for North Carolina Hospitals  

An emergency department (ED) visit is a critical point where patients with an opioid use disorder can be introduced to life-saving treatments that serve as a gateway to recovery. Medications for opioid use disorder (MOUD), including opioid agonist (such as methadone) and partial agonist (such as buprenorphine) medications, has been identified as the gold standard for evidence-based treatment of opioid use disorder (OUD) due to its ability to temper the withdrawal symptoms that make it difficult for people with OUD to stop using opioids, and to help protect against overdose.  

This toolkit was developed by the North Carolina Healthcare Foundation (NCHF) to be a resource and implementation guide to help North Carolina hospitals start an ED-based buprenorphine treatment program in their facilities. It was funded by the NC Division of Public Health, Injury and Violence Prevention Branch (IVPB), and was co-designed in collaboration with Dr. Christopher Griggs (Atrium Health), Dr. Genevieve Verrastro (MAHEC Faculty, Special Projects; UNC Associate Professor of Medicine), and four NC hospitals (UNC Health Chatham Hospital, UNC Health Southeastern, FirstHealth Montgomery Memorial Hospital, and Randolph Health). It was then tested and refined based on the experiences of pilot sites across the state (Atrium Health Wake Forest Baptist Wilkes Medical Center; Blue Ridge Regional Hospital; Cone Health Wesley Long Hospital/Cone Health Guilford County Behavioral Health Urgent Care; Cone Health Women’s and Children’s Center; Hugh Chatham Memorial Hospital; Mission Hospital; UNC Health Chatham Hospital; and Washington Regional Medical Center).  

Full Toolkit 

ED-Based Buprenorphine Induction Workflow (One-Pager)

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