California Successfully Expands Emergency Department-Based Addiction Treatment Nationwide

A recent comprehensive study highlights the impressive progress of California's CA Bridge program, which has effectively expanded opioid-use disorder treatment services across more than 80% of the state's emergency departments. From July 2022 to December 2023, the program engaged over 165,000 patients and facilitated nearly 45,000 instances of buprenorphine treatment, a medication proven to reduce overdose deaths.

This initiative demonstrates that emergency departments can serve as vital entry points for addiction care when provided with targeted funding, specialized training, and patient navigation support. The study, published in the journal Health Affairs, emphasizes that with these resources, emergency departments can initiate life-saving treatment and connect patients to ongoing care.

Data collected from 252 hospitals across California show the program's extensive reach. The hospitals received funding of $120,000 each to hire patient navigators, support clinical champions, and establish addiction treatment pathways. The program utilized grant reports and controlled substances prescribing data to track patient engagement, buprenorphine prescriptions, and follow-up care, revealing significant improvements in treatment initiation, especially at public hospitals.

Between June 2022 and December 2023, over 165,671 ED visits involved patient engagement through navigators. Notably, public hospitals had an 80% higher patient engagement rate, and buprenorphine treatment provision was about 50% higher in these hospitals compared to private ones.

In 2022 alone, over 119,000 individuals in California received buprenorphine prescriptions for opioid-use disorder, with 4.3% initiated by emergency clinicians. Of those receiving first-time prescriptions, 5.3% started treatment in the ED, with many clinicians prescribing for the first time. Nearly 36% of patients received follow-up prescriptions within 40 days, and patients generally maintained a median treatment duration of 58 days within the first month.

Experts advocate that the success of CA Bridge underscores the potential of emergency departments to become effective sites for addiction treatment, provided there is sustainable funding, standardized quality metrics, and ongoing support. Future efforts should explore ways to replicate and expand this model, including addressing other substance-use disorders like methamphetamine and alcohol.

Dr. Elizabeth Samuels, a lead researcher in the study, emphasized the significance of the findings, stating that the program offers a scalable model for integrating low-barrier buprenorphine treatment into diverse clinical settings. The initiative paves the way for nationwide policies aimed at improving emergency department addiction services and reducing opioid-related fatalities.

Source: https://medicalxpress.com/news/2025-09-california-successfully-scales-emergency-department.html