Improving Care for Individuals With Opioid Use Disorder in the Emergency Department Setting

Endorsed in:

September, 2024

Paper Type:

Policy Paper

Authors:

Mindy Lu*

Christine M. Lam*

*These authors contributed equally to this work

Background:

The opioid crisis in Canada, marked by 40,620 toxicity deaths from January 2016 to June 2023 and a
165% increase in opioid-related emergency department (ED) visits in Ontario from 2009 to 2019,
demands immediate action. Since the 1980s, the crisis has been fueled by a 3000% increase in opioid
prescriptions and inadequate oversight, leading to widespread misuse. Vulnerable groups, including
low-income individuals, people experiencing homelessness, and First Nations communities, are
disproportionately affected due to socioeconomic challenges (3,6). People who use drugs in Ontario visit
EDs seven times more than the general population, yet often face inadequate care, with 19% leaving
before being seen. Despite the proven benefits of opioid agonist therapy (OAT) and its incorporation into
the guidelines for management of opioid-use disorder, its use remains low among ED patients, with only 1
in 18 receiving OAT. Urgent action is needed to improve access to OAT and enhance care through
evidence-based strategies and medical education.

Recommendations:

Implementation of comprehensive, standardized protocols for screening and treatment of
substance use disorders.
Supplementary training on trauma-informed care for all medical trainees and healthcare providers
working in emergency and urgent care centres.
Streamlined access to follow up care and support for substance use disorders.
Comprehensive opioid toxicity training for medical learners.