The overdose crisis is prompting more hospitals to initiate opioid addiction treatment in emergency rooms — a change welcomed by many behavioral health experts. It is resurfacing tension among providers over who's really responsible for addressing the underlying problem of opioid misuse, Axios reports. Discharged patients are referred to substance use programs in communities. Addiction experts say administering a drug to treat dependence like buprenorphine in a hospital can dramatically reduce the odds of a patient relapsing and provide a critical intervention. It’s still more common for the burden to be placed on patients to "go and figure it out themselves," said Alister Martin, an emergency physician and founder of Get Waivered, a campaign pushing for more emergency departments to provide buprenorphine.
Less than 10% of nearly 150,000 drug-related emergency visits resulted in a buprenorphine prescription between August 2019 and April 2021, says a 2021 University of Michigan study. Nearly 20 years after the Food and Drug Administration approved buprenorphine, only 1 in 9 providers were licensed to prescribe it. The year-end congressional spending package eliminated a requirement that clinicians undergo special training and register to prescribe buprenorphine, a factor doctors often cited as a barrier to offering treatment. Some ER doctors "just don't consider it part of their job" and view addiction as a "moral failing" instead of a medical illness, said Eric Weintraub, a psychiatrist who leads the University of Maryland’s Division of Addiction Treatment and Research. Some also don't want emergency departments — high-volume businesses with high fixed costs — to be de facto substance use clinics treating a large number of uninsured or Medicaid patients. The scope of the opioid crisis has prompted more states to make addiction treatment in ERs an option.