Buprenorphine
| Level |
Direction |
Primary Outcome |
Patient/Process |
Setting |
Reference |
|
I
|
Supportive (Green)
|
Retention in treatment
|
Process
|
ED-MD
|
Armour R, Nielsen S, Buxton JA, Bolster J, Han MX, Ross L. Initiation of buprenorphine in the emergency department or emergency out-of-hospital setting: A mixed-methods systematic review. Am J Emerg Med Nov 2024; 88:12-22. Medline
|
|
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)
|
Incidence of buprenorphine-precipitated withdrawal
|
Patient
|
Other
|
Gregory C, Yadav K, Linders J, Sikora L, Eagles D. Incidence of buprenorphine-precipitated opioid withdrawal in adults with opioid use disorder: A systematic review. Addiction Jan 2025; 120(1):7-20. 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)
|
Identification of implementation challenges
|
Patient
|
ED-Paramedic & MD
|
Bailes Iv P, Gormley MA, Floyd SB, et al. Barriers to Buprenorphine: A Case Series of Misadventures Implementing a Prehospital Buprenorphine Protocol. Prehosp Emerg Care Jan 2025; 1-7. 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)
|
Symptom relief of opiate withdrawal.
|
Patient
|
PH-Paramedic
|
Gurley AL, Lacocque J, Mercer MP, et al. Prehospital Buprenorphine in Treating Symptoms of Opioid Withdrawal - A Descriptive Review of the First 131 Cases in San Francisco, CA. Prehosp Emerg Care Jan 2025; 1-6. 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
|
|
III
|
Neutral (Yellow)
|
Pt avoidance of fentanyl use
|
Patient
|
ED-MD
|
Taylor JL, Gott J, Weisenthal K, Colicchio P, Dyer S, Komaromy MS. Post-Overdose Extended-Release Buprenorphine Initiation Facilitated by a Partnership Between Emergency Medical Services and an Outpatient Substance Use Disorder Observation Unit. Subst Use Addctn J 2024; 45(4):771-6. Medline
|