Statewide expansion of emergency department addiction treatment proves successful in California

In a significant stride towards combating the opioid crisis, California's CA Bridge program has demonstrated the transformation of emergency departments into effective sites for opioid use disorder treatment and linkage to maintenance care. The program, which received funding from the California Department of Health Care Services, the California Health Care Foundation, the Public Health Institute, and the National Association of County and City Health Officials, has successfully implemented opioid use disorder treatment services in over 80% of California's emergency departments.

According to a study led by Dr. Elizabeth Samuels at UCLA, the CA Bridge program reached over 165,000 patients and provided nearly 45,000 instances of buprenorphine treatment from July 2022 through December 2023. The program engaged patients with opioid use disorders in over 165,671 emergency department visits at CA Bridge participating hospitals.

The program's success is evident in the increase of first-time buprenorphine prescriptions. In 2022, 5.15% of people receiving a first-time buprenorphine prescription in California did so from an emergency medicine clinician. Notably, nearly 22% of emergency clinician prescribers in California were new to prescribing buprenorphine, indicating a growing number of healthcare professionals equipped to address opioid use disorders.

The CA Bridge model, which cost $40 million from the state general budget, provided hospitals with funding, technical assistance, and training to establish addiction treatment pathways. This investment has proven to be fruitful, with patient engagement at public hospitals being about 80% higher than at private hospitals.

The Health Affairs September 2025 issue on "Insights About the Opioid Crisis" includes the latest empirical research and policy perspectives, offering a comprehensive look at the ongoing efforts to combat the opioid crisis. The issue is available at https://www.healthaffairs.org/opioids.

The authors of the study assume full responsibility for the accuracy of ideas presented, which do not represent the views of supporting institutions. The success of the CA Bridge program could inform national policy discussions about expanding emergency department addiction services, offering a potential roadmap for nationwide implementation of emergency department addiction treatment initiatives.

The CA Bridge program has demonstrated the potential of emergency departments as effective sites for opioid use disorder treatment and linkage to maintenance care. As the fight against the opioid crisis continues, programs like CA Bridge provide a promising avenue for improving access to treatment and saving lives.