Why Patients Decline ED-Initiated Buprenorphine: Addressable Fears, Not Low Readiness

This mixed-methods study identifies the specific patient-driven barriers (precipitated withdrawal fear, dependence aversion, housing conflicts) that behavioral health pharmacists can target to improve uptake of emergency department-initiated buprenorphine.

📅 Journal publication: Oct 1, 2026 · Last updated: Oct 8, 2026

buprenorphinemethadonelong-acting injectable buprenorphineopioid use disordermedications for opioid use disorderemergency departmentprecipitated withdrawalqualitative studyaddiction medicineSOCRATEStreatment retentionharm reduction Behavioral Health / Addiction Medicine

Background Information

Patient concerns limit emergency department buprenorphine acceptance.

Understanding patient barriers to emergency department-initiated buprenorphine (EDIB) can improve acceptance and outcomes in opioid use disorder (OUD) treatment. 23% declined EDIB; barriers included concerns about withdrawal (50%), dependency (32%), and logistical issues (23%). Addressing specific concerns like precipitated withdrawal and logistical barriers may enhance buprenorphine uptake in the emergency setting. Targeted interventions can improve buprenorphine uptake in the emergency department for OUD patients.

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Authors: Jennings LK, Barth K, Lane S, Rafferty A, Papa C, Haynes L, Sonne S, McCowin H, Moschella P, Litwin AH, Manteuffel JJ, Brady K, Moreland A

Citation: Jennings LK, Barth K, Lane S, et al. Patient Perspectives on Offers of Buprenorphine in the Emergency Department. JAMA network open. 2026;9(10):e2637671. doi:10.1001/jamanetworkopen.2026.37671

Article Links: PubMed · Journal / DOI · Free Full Text (PMC)

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Executive Summary

Study Design

Patient Population

Primary Outcomes

Secondary Outcomes & Safety Profile

Pharmacist Implications

Clinical Pearls

Limitations

Controversies & Evidence Gaps

Cost & Logistics

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