ArticleBMC emergency medicine2021
A qualitative examination of the current management of opioid use disorder and barriers to prescribing buprenorphine in a Canadian emergency department.
Article in BMC emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Physician Reluctance to Intervene in Addiction: A Systematic Review.JAMA network open · 2024Pooled it
- Reducing perceived barriers to scaling up overdose education and naloxone distribution and medications for opioid use disorder in the United States in the HEALing (Helping End Addiction Long-Term®) communities study.Preventive medicine · 2024Trial
- The role of emergency departments in opioid related harms: A qualitative study among emergency healthcare providers.PloS one · 2025Article
- Physician perspectives on reducing harm and supporting emergency department patients who use drugs.PloS one · 2025Article
- Opioid-specific harm reduction in the emergency department: how staff provide harm reduction and contextual factors that impact their capacity to engage in harm reduction practice.Harm reduction journal · 2024Article
- Perspectives on and experiences of emergency department-initiated buprenorphine among clinical pharmacists: A multi-site qualitative study.Journal of substance use and addiction treatment · 2023Article
- A conceptual framework for how structural changes in emerging acute substance use service models can reduce stigma of medications for opioid use disorder.Frontiers in psychiatry · 2023Article
- Emergency Physicians Ability to Recognize and Diagnose Opiate Use Disorder: A Qualitative Study.Cureus · 2021Article
- Prescribing Buprenorphine for Opioid Use Disorders in the ED: A Review of Best Practices, Barriers, and Future Directions.Open access emergency medicine : OAEM · 2020Review
- Article
- Bridging the Gap: Canadian Healthcare Providers' Perspectives of Harm Reduction and Substance Use Education in Hospital.Journal of the American Psychiatric Nurses AssociationArticle
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEmergency departments (EDs) across Canada are increasingly prescribing buprenorphine for opioid use disorder (OUD). The objective of this study was to identify the current knowledge, attitudes, and behaviours of ED physicians on the management of OUD in the ED, including barriers and facilitators to prescribing buprenorphine.
methodsWe purposefully selected emergency physicians from one ED in Toronto which had recently received education on OUD management and had a new addiction medicine follow-up clinic, to participate in semi-structured interviews. We used semi-structured interviews to explore experiences with patients with OUD, conceptions of role of the ED in addressing OUD, and specifically ask about perceptions and experience on using buprenorphine for opioid withdrawal. Our analysis was informed by constructivist grounded theory to help uncover contextualized social processes and focus on what people do and why they do it. Two researchers independently coded transcripts using an iterative constant comparative and interpretative approach.
resultsResults fell broadly into facilitators and barriers. Generally, management of OUD in the ED varied significantly. Physician-level facilitators to treating opioid withdrawal with buprenorphine included: knowledge about OUD an7d buprenorphine, positive experiences with substitution therapy in the past, and the presence of physician champions. Systems-level facilitators included timely access to follow-up care and pre-printed order sets. Barriers included provider inexperience, lack of feedback on treatment effectiveness, limited time to counsel patients, and pressure to discharge patients quickly. Additional barriers included concerns about precipitating withdrawal, prescribing a chronic medication in acute care, and patient attitudes.
conclusionThis study describes barriers and facilitators to addressing OUD and prescribing buprenorphine in a Canadian ED. These findings suggest a role for additional provider education, involvement of allied health professionals in counseling, and mentorship by physician champions in the department.
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