Buprenorphine was a fantastic drug in the emergency department. Patients would come to our ED feeling awful from opiate withdrawal, and we made them feel so much better. We can recall so many patients coming in vomiting, anxious, sweaty, dehydrated, and looking awful — and with one or two shots of buprenorphine, we made them feel well enough to take on the task of beating opiate addiction. A clinic in our community could see these patients in a day or so and start the process of treating their opiate addiction with oral Suboxone (buprenorphine and naloxone). The system worked. We ED docs loved it, and our patients benefitted immensely. Our experience was confirmed by a 2015 study on buprenorphine/naloxone in the emergency department at Yale University, which demonstrated — in a randomized controlled trial — that patients treated with buprenorphine in the emergency department were significantly more likely to be engaged in addiction treatment, significantly less likely to use illicit opioids, and significantly less likely to need inpatient addiction treatment.

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