09.Issue 10 october 25 - INDO AMERICAN JOURNAL OF PHARMACEUTICAL SCIENCES

Volume : 12, Issue : 10, October – 2025

Title:

THE EMERGENCY DEPARTMENT’S ROLE IN ADDRESSING OPIOID USE DISORDER: A SYSTEMATIC REVIEW OF SCREENING, REFERRAL, AND BUPRENORPHINE INITIATION PROTOCOLS
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Authors :

Mohammad Hadi Almansour, Jafar Mubarak Al Murdhimah, Mohammed Saleh Al-Ghamdi, Meshal Ahmed Aledaini, Ayman Mabrook Al Yami, Ahmed Dhafer Alasmari, Rayan Talal Alnahari, Essa Mohammed Albuhayri, Abdullah Mousa Aleryani

Abstract :

The opioid crisis constitutes a major public health emergency, with emergency departments (EDs) serving as a critical point of access for individuals with opioid use disorder (OUD). However, the traditional ED model of acute stabilization without linkage to treatment represents a missed opportunity. This systematic review synthesizes evidence on the effectiveness of ED-based protocols for OUD screening, referral, and buprenorphine initiation. A systematic search was conducted in PubMed, Embase, Cochrane Library, CINAHL, PsycINFO, and Web of Science from inception to 2024, following PRISMA guidelines. The PICOS framework was used to include studies evaluating ED-based OUD interventions in adults. Twenty studies met the inclusion criteria, including randomized controlled trials, cohort studies, and implementation studies. Data were extracted and synthesized narratively. The evidence strongly supports the effectiveness of integrated ED interventions. Systematic screening using tools like the NIDA Quick Screen successfully identifies patients with OUD. Active referral strategies, such as warm handoffs and peer navigators, significantly improve linkage to care (30-60% success rates) compared to passive referral (<10%). ED-initiated buprenorphine is a cornerstone intervention, doubling 30-day treatment engagement (78% vs. 37% in a landmark RCT) and proving feasible and safe across diverse ED settings, including rural and low-resource hospitals. Key facilitators for implementation include clinical champions, electronic health record support, and staff education, while persistent barriers include stigma, workflow constraints, and fragmented community care. The ED is a vital and effective setting for initiating evidence-based OUD care. A multi-faceted approach combining systematic screening, active referral, and buprenorphine initiation significantly improves patient outcomes. Successful implementation requires structured protocols, trained staff, and robust community partnerships. Widespread adoption of this model is essential for EDs to fulfill their potential in combating the opioid crisis.
Keywords: Opioid Use Disorder, Emergency Department, Buprenorphine, Screening, Referral and Consultation, Harm Reduction.

Cite This Article:

Please cite this article in press Mohammad Hadi Almansour et al., The Emergency Department’s Role In Addressing Opioid Use Disorder: A Systematic Review Of Screening, Referral, And Buprenorphine Initiation Protocols, Indo Am. J. P. Sci, 2025; 12(10).

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