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TOPLINE:

Implementation of the Opioid Overdose Recovery Program (OORP) in emergency departments (EDs) led to a 2.3-fold increase in initiation of medications for opioid use disorder (MOUDs), better treatment engagement, and enhanced psychosocial care but did not reduce repeat overdoses.

METHODOLOGY:

• Researchers conducted a retrospective cohort study using New Jersey Medicaid claims (2015-2020) linked to OORP participant data, including 7109 overdose events among 5475 patients treated for nonfatal opioid overdose (62.2% men; mean age, 40.1 years; 28.1% Black, 8.0% Hispanic, and 56.1% White).
• Patients who enrolled in OORP (n = 1410) were compared with a propensity score-matched group of nonparticipants (n = 5699) treated in EDs without OORP.
• The OORP intervention consisted of peer-delivered ED bedside support, followed by 8 weeks of peer contacts (three in week 1, two in week 2, and weekly thereafter) and service linkage assistance.
• The primary outcome was MOUD initiation within 60 days of discharge, and secondary outcomes included MOUD continuity, psychosocial treatment initiation and engagement, acute care utilization, and repeat opioid or any drug overdose over 180 days.

TAKEAWAY:

• OORP participants had higher rates of 60-day MOUD initiation (15% vs 12%; hazard ratio [HR], 2.31; 95% CI, 1.55-3.45) and psychosocial service use (16% vs 11%; HR, 1.73; 95% CI, 1.13-2.65) within 60 days than nonparticipants.
• Participants had an increase of 3.6 percentage points in days covered on MOUDs during the 180-day follow-up period (95% CI, 0.72-6.47) and an increase of 12 percentage points in the probability of psychosocial treatment engagement (95% CI, 7.23-16.73).
• Participants had slightly fewer repeat inpatient or ED visits for any cause during follow-up than nonparticipants (58% vs 60%; HR, 0.83; 95% CI, 0.72-0.97).
• No significant differences were observed in rates of repeat opioid overdose, any drug overdose, or opioid-related ED or inpatient visits during follow-up.

IN PRACTICE:

"[These] findings suggest that peer support can improve treatment linkages and reduce ED and inpatient utilization following ED-treated opioid overdose. However, we did not find an association of peer services with repeat overdose, suggesting that additional efforts are needed to retain patients in medications for opioid use disorder long term and reduce their overdose risk," the authors wrote.

SOURCE:

The study was led by Peter Treitler, PhD, Boston University School of Social Work, Boston. It was published online on August 6, 2025, in Annals of Emergency Medicine.

LIMITATIONS:

These findings applied only to stably enrolled New Jersey Medicaid beneficiaries, limiting generalizability. Also, the 2015-2020 study period did not reflect more recent changes in illicit drug supply or the evolution of ED-based opioid use disorder services. Service delivery varied across facilities and over time, and unmeasured factors such as readiness for change may have differed between groups. Non-Medicaid care, including overdoses not resulting in medical treatment and nonreimbursed psychosocial services, was not captured. Additionally, prescription fills were used to track initiation, but actual use was not verified.

DISCLOSURES:

The study received support from Arnold Ventures, the National Institutes of Health (NIH) through the NIH HEAL Initiative, and the National Institute on Drug Abuse, with additional support from the National Center for Advancing Translational Sciences. The authors reported having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.