# Effectiveness of Bridge Clinic Following Emergency Department-Initiated Intervention for Opioid Use Disorder

> **NIH NIH R21** · UNIVERSITY OF VERMONT & ST AGRIC COLLEGE · 2020 · $193,191

## Abstract

Project Summary
The current US opioid epidemic is one of the most serious public health emergencies in recent history. Opioid-
related overdose deaths have quadrupled since 1999 making drug overdose the new leading cause of
accidental death in the U.S. One of the greatest challenges in addressing the crisis is connecting individuals
with opioid use disorders (OUD) with the medical resources they need. Only 10.8% of the estimated 21.7
million people in the U.S. with a past year substance use disorder received specialized addiction treatment.
Currently, the Emergency Department (ED) represents a critical missed opportunity to identify and engage
patients with OUD in Medication-Assisted Treatment (MAT). To seize this opportunity, a novel ED intervention
for OUD at three hospitals within the University of Vermont Health Network is being implemented in 2019
funded by a clinical expansion grant from SAMHSA. Patients presenting with OUD are given the option to
immediately start MAT with Naloxone/Buprenorphine (bup/nal) at the ED then referred to a local provider for
further treatment. At one of the hospitals, the referral is made to a specialized addiction bridge clinic which
monitors patients until the individual is stabilized and transferred to a long-term MAT provider or referred to a
higher level of care. Referrals from the ED at the other two hospitals are made directly to a local physician who
has been waivered to prescribe buprenorphine. The purpose of this study is to characterize the outcomes of
this novel intervention. The primary outcomes measured will be illicit opioid use and treatment retention at 1
week, 3 months and 6 months after initiation of treatment at the ED. These outcomes will be compared to a
literature benchmark on this intervention which observed 73% treatment enrollment and low rates illicit opioid
use at 2 months after treatment initiation. Outcomes will also be compared between the hospitals with and
without the bridge clinic. It is hypothesized that referrals to a specialized addiction bridge clinic will be
associated with improved primary outcomes relative to direct referrals to a local waivered physician.
Demographic and behavioral data collected at intake will be used to develop a profile of the patients most likely
to benefit from the intervention at follow-up. It is expected that a group of patients sharing a common set of
characteristics may derive no benefit from the intervention. The behavioral predictors of patients who will
benefit from the intervention will be used to develop an efficient short screen to assist ED medical staff identify
and appropriately treat patients presenting with symptoms of OUD.

## Key facts

- **NIH application ID:** 10017033
- **Project number:** 5R21DA049859-02
- **Recipient organization:** UNIVERSITY OF VERMONT & ST AGRIC COLLEGE
- **Principal Investigator:** Scott Mackey
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $193,191
- **Award type:** 5
- **Project period:** 2019-09-30 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10017033

## Citation

> US National Institutes of Health, RePORTER application 10017033, Effectiveness of Bridge Clinic Following Emergency Department-Initiated Intervention for Opioid Use Disorder (5R21DA049859-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10017033. Licensed CC0.

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