CA Bridge
Hospital emergency departments (EDs) are an underutilized resource in the fight against the overdose crisis. The CA Bridge model leverages 24/7 access to care and medical wrap-around services, including key elements:
- Immediate access to medication for addiction treatment
- Navigation to ongoing care in the community
- A culture of harm reduction
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Focus Areas
Alcohol, Tobacco, Drugs & Mental Health, Health Care & Population Health -
Issues
Rural Health -
Expertise
Health Education & Promotion, Outreach & Dissemination, Technical Assistance -
Strategic Initiatives
COVID-19, Opioids
Our Impact
- 95K patients have seen a navigator
- 90K patients have been identified with opioid use disorder
- 40K patients have been treated with medication for opioid use disorder
Projects
Active Projects
- Contra Costa County EMS Partnership for Opioid Response
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After paramedics respond to a 911 call to reverse an opioid overdose, they have a unique opportunity to offer these very high-risk patients treatment for their underlying addiction. Contra Costa is the first county in California to obtain approval for a pilot project to offer this treatment by enabling paramedics to administer buprenorphine (medication for the treatment of opioid use disorder) from the ambulance and follow-up with outreach to connect patients to ongoing care. CA Bridge is collaborating with the County and UCLA to study the impact of this intervention and to share these practices with other county EMS agencies.
- Youth Opioid Response
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There are unique challenges faced by young people who use drugs. Adolescents and young adults are experiencing fast-growing rates of opioid overdose and hospitalization, yet have the lowest rates of access to treatment. A landmark randomized controlled study demonstrated that our Emergency Departments are uniquely positioned to reverse these trends and provide a lifeline to people facing addiction. This project will demonstrate the effectiveness of youth-focused outreach, education, and service delivery for substance use disorder treatment to better serve this vulnerable population.
- Bridge Navigator Program
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CA Bridge will implement the Bridge Navigator Program that will make funding available to 300 emergency departments across California to make access to treatment for substance use disorder and mental health navigation accessible 24/7. Funded hospitals will implement evidence-based treatment for opioid use disorder and hire behavioral health navigators to engage patients and connect them to ongoing outpatient treatment. In addition to administering funding, CA Bridge will provide extensive outreach, training, and technical assistance to make addiction treatment the standard of care in California emergency departments.
Completed Projects
- CA Bridge - Core Support
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When we create universal access to MAT throughout California hospital emergency rooms, we will have reached a scale unmatched by any other state. This will have tremendous positive implications on rates of addiction, overdose, and death, along with a reduction in the social costs of addiction. The National Institute on Drug Abuse estimated in 2011 that nationwide, substance abuse costs $740 billion a year in costs related to crime, lost work productivity, and health care--a number that has only increased in the intervening years. Because our work is pushing the boundaries of how people who use drugs receive care, it has important national implications. Our model is already having an impact outside of California; our web resources have been downloaded by clinicians in 26 other states with elements of the CA Bridge model being replicated in Colorado, Texas, and West Virginia. Across the country, we are seeing a greater movement towards approaches in hospitals that lower barriers to care and put the needs of the patient first.
- National Emergency Department MAT Initiative
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The CA Bridge Program, a program of the Public Health Institute, is one of three partners launching a national initiative to increase access to medication for addiction treatment (MAT) through emergency departments. Only an estimated 5% of people with substance use disorder (SUD) receive MAT, an evidence-based treatment. Our goal is that hospitals will treat SUD with the same priority as any other life-threatening chronic illness. Within the proposed national initiative, CA Bridge will focus on building capacity for the delivery of MAT in acute care settings.
Our strategies include: development of tools and resources for MAT in acute care settings; delivery of training to hospitals in and outside of California; and technical assistance on MAT implementation to hospitals, health systems, and partners.
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