PCSS-MOUD On-Demand Webinar: Emergency Department Initiated MOUD: Practical Tips and Innovations-Presentation

Video Transcription

Video Summary

The presentation focused on emergency department-initiated medications for opioid use disorder, especially buprenorphine, with some discussion of methadone and naltrexone. Dr. Campbell emphasized that overdose is a major public health crisis and that EDs should be prepared to offer rapid, low-barrier treatment rather than simple referral. She framed treatment goals as protection from overdose and infection, remission of symptoms, and long-term recovery, all supported by medication plus behavioral and social services.<br /><br />A case example of “Charles” illustrated recognizing opioid withdrawal even when patients present with another complaint. The talk reviewed evidence that buprenorphine reduces mortality, improves retention in treatment, and can be safely started in higher doses. She discussed several initiation strategies: traditional abstinence-and-withdrawal-based induction, low-dose overlap approaches, and direct-to-inject extended-release buprenorphine, which can engage patients earlier and avoid some barriers. She also described how naloxone-reversed overdose patients can be started on buprenorphine in the field or ED.<br /><br />A major theme was team-based care: nurses, peers, pharmacists, clerks, and navigators all need training and consistent messaging. Successful programs also require data tracking, strong follow-up pathways, and kind, stigma-free care.

Keywords

opioid use disorder

emergency department

buprenorphine

methadone

naltrexone

overdose

withdrawal

low-barrier treatment

team-based care