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Opioid withdrawal

Date Last Search Run: Jun 11, 2024
Table last updated: Sep 16, 2023
Data last added: Jun 27, 2024

1 (strong evidence exists)        
2 (fair evidence exists)    
3 (weak evidence exists)      


Level Direction Primary Outcome Patient/Process Setting Reference
II Supportive (Green) Withdrawal symptoms Process PH-Paramedic Carroll G, Solomon KT, Heil J, Saloner B, Stuart EA, et al. Impact of Administering Buprenorphine to Overdose Survivors Using Emergency Medical Services. Ann Emerg Med 2022. Medline
II Supportive (Green) Compliance with treatment Patient ED-MD Krenz JR, Hayes BD, Wakeman SE, Martin A, Raja AS, White BA, Koehl JL. Continuation of outpatient buprenorphine therapy after dispensing Buprenorphine-Naloxone from the emergency department. Clin Toxicol 2022; 60(4):429–32. Medline
II Supportive (Green) Successful implementation Patient ED-MD McCormack RP, Rotrosen J, Gauthier P, et al. Implementing Programs to Initiate Buprenorphine for Opioid Use Disorder Treatment in High-Need, Low-Resource Emergency Departments: A Nonrandomized Controlled Trial. Ann Emerg Med Sept 2023; 82(3):272-87. Medline
II Supportive (Green) Follow-up treatment engagement Patient ED-MD Snyder H, Chau B, Kalmin MM, et al. High-Dose Buprenorphine Initiation in the Emergency Department Among Patients Using Fentanyl and Other Opioids. JAMA Netw Open March 2023; 6(3):e231572. Medline
III Supportive (Green) Prevention of withdrawal symptoms Patient ED-MD Carroll GG, Wasserman DD, Shah AA, Salzman MS, Baston KE, Rohrbach RA, Jones IL, Haroz R. Buprenorphine Field Initiation of ReScue Treatment by Emergency Medical Services (Bupe FIRST EMS): A Case Series. Prehosp Emerg Care. 2021 Mar-Apr;25(2):289-293. doi: 10.1080/10903127.2020.1747579. Epub 2020 May 4. PMID: 32208945. Medline
III Supportive (Green) Decrease in symptoms Patient PH-Paramedic & MD Hern HG, Goldstein D, Kalmin M, Kidane S, Shoptaw S, Tzvieli O, Herring AA. Prehospital Initiation of Buprenorphine Treatment for Opioid Use Disorder by Paramedics. Prehosp Emerg Care. 2021 Nov 22:1-7. doi: 10.1080/10903127.2021.1977440. Epub ahead of print. PMID: 34505820. Medline
III Supportive (Green) Program efficacy Patient ED-MD Regan S, Howard S, Powell E, Martin A, Dutta S, Hayes BD, et al. Emergency Department-initiated Buprenorphine and Referral to Follow-up Addiction Care: A Program Description. J Addict Med 2022; 16(2):216–22. Medline
III Supportive (Green) demographic description and patient experience with buprenorphine Patient Other Robbins M, Haroz R, Mazzarelli A, 4th Clements D, Jones CW, Salzman M. Buprenorphine use and disparities in access among emergency department patients with opioid use disorder: A cross-sectional study. J Subst Abus Treat 2021; 130:108405. Medline

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