Table 3 Barriers and facilitators to offering specific substance use disorder-related services

Screening

What barriers does your ED face related to screening patients for substance use disorder? ^a

 Need to triage competing medical problems

36

42%

 Lack of clinical knowledge/training in administering substance use disorder screening

33

39%

 Screening patients for substance use disorder is not part of the ED protocol

32

38%

 Lack of adequate substance use disorder screening tools

30

35%

 Screening is not embedded within the EMR

30

35%

 Lack of time

25

29%

 Lack of training in what to do with a positive screen

25

29%

 Nowhere to refer patients with a positive screen

23

27%

 Patient privacy concerns (e.g., family member or significant other will not leave the room)

23

27%

 Some staff are uncomfortable screening patients for substance use disorder

12

14%

 Other

10

12%

What factors make it easier to screen patients for substance use disorder? (n = 37)^{a, b}

 Substance use disorder screening is embedded in the EMR

31

84%

 Substance use disorder screening is part of the ED protocol

18

49%

 Providers have clinical knowledge/training in administering substance use disorder screening

12

32%

 Providers know how/where to refer patients with a positive screen

11

30%

 Providers are comfortable administering substance use disorder screenings

10

27%

 Providers are trained in what to do with a positive screen

9

24%

 ED has a champion who has led education efforts about screening for substance use disorder

4

11%

 Other

2

5%

MOUD

Rank your level of agreement with the following statement: Patients with opioid use disorder in the ED can receive buprenorphine in a timely manner.

 Strongly disagree

6

7%

 Disagree

6

7%

 Neither agree nor disagree

24

28%

 Agree

26

31%

 Strongly agree

13

15%

 Not Applicable

10

12%

What barriers are there to prescribing take-home buprenorphine?^a

 Lack of providers that have/had an X-waiver to prescribe buprenorphine ^c

56

66%

 Lack of clinician willingness to prescribe buprenorphine

44

52%

 Lack of clinician knowledge in how to induct patients on buprenorphine

41

48%

 Clinicians often will not prescribe buprenorphine unless patients are connected to counseling or treatment

36

42%

 Lack of knowledge that patients can receive take-home buprenorphine from X-waivered providers

30

35%

 No community providers to continue prescriptions after take-home supply runs out

29

34%

 Lack of time to follow up with patient when they leave the ED

28

33%

 Pharmacy does not stock buprenorphine or maintain adequate supplies

21

25%

 Lack of patient interest

9

11%

 Limited access to pharmacy or long wait times

9

11%

 Other

8

9%