The most cost effective way to treat opioid dependence in the ED

Giving patients buprenorphine to treat their opioid dependence in the emergency department is more cost-effective than referring them to a community treatment center or implementing a brief intervention, according a study published in the journal Addiction.

For the study, researchers compared the relative cost of the three treatment strategies randomly assigned to patients admitted to the ED who screened positive for opioid addiction. The team compared the estimated costs of care for the first 30 days after ED admission. Costs included ED care, addiction treatment, inpatient and outpatient costs and medications. The research team determined treatments to be effective based upon patient engagement in addiction treatment at 30 days post ED admission.

Treatment with buprenorphine was the most cost-effective treatment option with a mean cost of $1,752. The mean cost of a brief intervention alone was $1,805 and the mean cost for a referral alone was $1,977. The ED-initiated buprenorphine group was nearly twice as likely to enroll in addiction treatment and used illicit opioids for fewer days during the 30 days after their ED visits. This group also used fewer illicit opioids over the study period.

"We were excited to learn that not only was ED-initiated buprenorphine more effective in engaging patients in treatment, but it was cost-effective," said senior author Gail D'Onofrio, MD, a professor in emergency medicine at Yale School of Medicine in New Haven, Conn. "All insurance payers and healthcare systems should be interested in these results."

More articles on opioids: 
Opioids prescribed post-surgery go unused more than 50% of the time 
Cincinnati targets 3 opioid distributors in lawsuit 
Opioid overdose-related ICU admissions up 34% over 7 years

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