EMED Study: Increasing Access to Buprenorphine/Naloxone Microdosing and Standard Dosing in Emergency Departments

Summary: People at risk for overdose commonly present to emergency departments (EDs), however opportunities to engage them in ongoing care are often missed. Buprenorphine/naloxone (Suboxone) prevents mortality and is effective at engaging people in care when initiated in EDs. However, barriers exist to its initiation, including the need to be in moderate to severe withdrawal during induction, and the risk of precipitating withdrawal if started too early. Microdosing is a novel method that avoids withdrawal by starting small doses that increase gradually. The EMED study is a multicentre randomized controlled trial that is the first to test the effectiveness of microdosing versus standard dosing in retaining patients on Suboxone and other opioid agonist therapies. Early study implementation has overcome many challenges of implementing a RCT in the fast-paced ED setting. Bio: Dr. Jessica Moe is an emergency physician at Vancouver General and BC Children’s hospitals, and an Assistant professor in Substance Use and Addictions with the UBC Department of Emergency Medicine. She holds a Masters in Clinical Epidemiology and is a Clinician Scientist with the BC Centre for Disease Control. Her research interests lie in improving ED identification of people at risk for overdose, decreasing barriers to harm reduction interventions and treatments, and understanding people with frequent ED presentations. She is currently leading a multicentre randomized controlled trial evaluating buprenorphine/naloxone microdosing and standard dosing in the ED, as well as a study implementing and evaluating continuous pulse oximetry for people who smoke drugs at overdose prevention sites in BC.

BC CDC Presenters

1/11/2022 8:00:00 PM