Abstract
IntroductionBuprenorphine benefits patients with opioid use disorder (OUD) in the emergency department (ED), but its efficacy for OUD patients with suicidal ideation (SI) in the ED is unknown.Case SeriesWe present a case series of 14 OUD patients with SI who were given buprenorphine and a referral to outpatient substance use treatment in the ED. All experienced SI resolution, engaged with outpatient services, and remained in outpatient substance use treatment 30 days after ED discharge.ConclusionOur data provide evidence for the feasibility of starting buprenorphine in OUD patients with SI in the ED, and suggest that buprenorphine may be useful in helping to resolve SI for these patients. Future research with larger samples is needed.
Highlights
Buprenorphine benefits patients with opioid use disorder (OUD) in the emergency department (ED), but its efficacy for OUD patients with suicidal ideation (SI) in the ED is unknown.Case Series: We present a case series of 14 OUD patients with SI who were given buprenorphine and a referral to outpatient substance use treatment in the ED
We present observational data on 14 OUD patients with SI who presented to the ED for treatment
Our goals were to explore the feasibility of starting buprenorphine in these patients in the ED, and to determine whether ED-initiated buprenorphine treatment would be associated with improvements in SI and engagement in outpatient substance use treatment
Summary
Case Series: We present a case series of 14 OUD patients with SI who were given buprenorphine and a referral to outpatient substance use treatment in the ED. The 99.4% increase in opioid-related visits to emergency departments (ED) between 2005-2014 represents an opportunity for EDs to encourage patients already in a vulnerable period to make behavioral changes.[5,6] This includes offering medication-based treatment with methadone and buprenorphine to OUD patients. Studies show that EDinitiated buprenorphine decreases opioid use and increases engagement in outpatient substance use treatment.[7,8] A limitation of these studies is that OUD patients with SI have been excluded, despite some evidence that buprenorphine might reduce SI.[9]
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