A collaboration with Massachusetts General Hospital

Supporting Patients with Opioid Use Disorder in the ER

Opioid Use Disorder (OUD) has reached crisis levels across the United States in recent years. Opioid-related overdose and death rates are skyrocketing, particularly on the nation’s east coast.

Massachusetts has one of the largest increases in opioid-related emergency department visits in the nation by far–and one of the largest increases in opioid-related overdoses and deaths, with rates growing four-fold since 2010. Countless headlines attest to the difficulties tackling this alarming public health crisis and providing appropriate evidence-based treatment for the many factors and behaviors that contribute to OUD.

ideas42 is collaborating with Massachusetts General Hospital (MGH) to explore insights and approaches from behavioral science to optimize their emergency department OUD treatment protocols and enable physicians to help more patients into effective, evidence-based treatment. MGH is on the front lines of the opioid epidemic, developing innovative approaches that treat substance use disorders along all levels of care—from primary community-based prevention to emergency intervention and treatment to chronic disease management. Key components of the initiative include an on-demand, transitional outpatient clinic and immediate access to buprenorphine in the hospital’s emergency department. We will develop interventions from a diagnosis process consisting of interviews with physicians, addiction specialists, nurse practitioners and physician assistants on staff, as well as MGH patients, to understand perceptions, attitudes, and beliefs related to seeking and receiving treatment for OUD within the emergency department.

With funding from the Laura and John Arnold Foundation, this collaboration spans multiple phases of diagnosis, design, and testing over the next 12 months. Following an investigation into the potential barriers and behavior drivers facing patients with OUD in emergency care, ideas42 will design a set of behavioral interventions to be piloted in MGH’s emergency room aimed at improving processes and outcomes for emergency medicine care teams, patients and outside support service providers. These tools will be designed in close collaboration with the hospital’s Emergency Medicine Department and Bridge Clinic for Addiction Recovery on the basis of promising behavioral science research and insights and adapted to fit the context, with an eye for future scale. They will then be rigorously tested using randomized controlled trials.

It is estimated that substance use disorder costs the United States health care system more than $700 billion annually. Effectively addressing opioid use disorder could result in tremendous public health benefit as well as substantial cost savings. Stay tuned for updates and insights from this effort to support patients in emergency care seeking treatment for OUD over the next year.

Interested in learning more about this work applying behavioral science to a crucial social problem? Reach out to us at info@ideas42.org or tweet at @ideas42 to join the conversation.