Evidence map›Paper›PMID 42236100›Full record

ArticleBMJ open2026

Emergency Department-initiated standard versus high-dose buprenorphine induction (ENVISION): a randomised clinical trial protocol.

Kathryn Hawk, Andrew Herring, Marek Chawarski, Erik S Anderson, Michael Baumann, Alyrene Dorey, August F Holtyn, Christopher Jones, Shara Martel, Patricia Owens and 6 more

Registry-linked trialAbstract read
In one paragraph

Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06494904 (ED-Initiated Standard Versus High Dose Buprenorphine Induction), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06494904 phase3recruitingnot on this map

ED-Initiated Standard Versus High Dose Buprenorphine Induction

TypeinterventionalSponsorYale UniversityRan2024 to 2028Enrolled360ConditionsOpioid Use DisorderArmsBuprenorphine
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Kathryn HawkDepartment of Emerency Medicine, Yale University School of Medicine, New Haven, Connecticut, USA kathryn.hawk@yale.edu.ORCID http://orcid.org/0000-0001-7435-5945
Andrew HerringDepartment of Emergency Medicine, Highland Hospital, Oakland, California, USA.
Marek ChawarskiDepartment of Emerency Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
Erik S AndersonDepartment of Emergency Medicine, Highland Hospital, Oakland, California, USA.
Michael BaumannDepartment of Emergency Medicine, Maine Medical Center, Portland, Maine, USA.
Alyrene DoreyDepartment of Emergency Medicine, The University of Utah School of Medicine, Salt Lake City, Utah, USA.
August F HoltynNational Institute on Drug Abuse Clinical Trials Network, Gaithersburg, Maryland, USA.
Christopher JonesDepartment of Emergency Medicine, Cooper Medical School of Rowan University, Camden, New Jersey, USA.ORCID http://orcid.org/0000-0001-9704-9094
Shara MartelDepartment of Emerency Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
Patricia OwensDepartment of Emerency Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
Kaitlin KmiecikThe Emmes Corporation, Rockville, Maryland, USA.
Tania D StroutDepartment of Emergency Medicine, Maine Medical Center, Portland, Maine, USA.
Peter TaillacDepartment of Emergency Medicine, The University of Utah School of Medicine, Salt Lake City, Utah, USA.
Michelle LofwallCenter on Drug and Alcohol Research, University of Kentucky, Lexington, Kentucky, USA.
Sharon L WalshCenter on Drug and Alcohol Research, University of Kentucky, Lexington, Kentucky, USA.
Gail D'OnofrioDepartment of Emerency Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe initiation of buprenorphine for patients with opioid use disorder (OUD) in the emergency department (ED) has been associated with improved outcomes including reduced ED visits and increased treatment engagement. Though both standard-dose (8 mg buprenorphine equivalent) and high-dose (24 mg buprenorphine equivalent) strategies to initiate buprenorphine have been used in the ED, no prospective trials comparing outcomes among patients receiving these treatments have been reported. METHODS AND ANALYSIS: This multisite randomised clinical trial is a multisite double-blind, double-dummy, randomised clinical trial enrolling 360 emergency department patients with moderate-to-severe OUD. Enrolled patients will be randomised to one of two study arms: standard-dose induction or high-dose induction, both provided in the ED. This study will engage, train and provide resources to five EDs throughout the US to recruit patients with untreated OUD into a randomised clinical trial. The primary aim is to evaluate the effects of the standard-dose induction and high-dose induction on rates of OUD treatment participation within 10 days post-randomisation. The secondary aims are to evaluate differences between standard-dose induction and high-dose induction on the outcomes of opioid craving, opioid withdrawal symptoms and illicit drug use assessed during 10 days post randomisation and evaluate the effects between treatment arms on rates of OUD treatment participation within 30 days post randomisation. ETHICS AND DISSEMINATION: This study is funded by the National Institute on Drug Abuse and has been approved by the WCG Instutitional Review Board. It has been registered at clinicaltrials.gov. This study will inform the strategy for treatment initiation with buprenorphine among diverse ED settings and will provide ongoing evidence to support the safety and efficacy of initiating treatment for OUD in the ED. TRIAL REGISTRATION NUMBER: NCT06494904.

Indexed as

Analgesics, OpioidBuprenorphineEmergency Service, HospitalNarcotic AntagonistsOpiate Substitution TreatmentOpioid-Related DisordersDouble-Blind MethodEmergency Room VisitsHumansMulticenter Studies as TopicPatient Acceptance of Health CareRandomized Controlled Trials as TopicResearch DesignTreatment OutcomeAnalgesics, OpioidBuprenorphineNarcotic AntagonistsClinical ProtocolsEmergency DepartmentsRandomized Controlled TrialSubstance misuse

Identifiers

PMID42236100
PMCPMC13239514

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.