The increasing morbidity and mortality of the opioid epidemic has necessitated a reevaluation of current addiction treatment paradigms: medications for opioid use disorder, such as buprenorphine and methadone, are effective in decreasing one's risk of death and disability from opioid use, but are underutilized and often difficult to access. The 5000 Emergency Departments (EDs) in the US are potential additional locales for medication initiation, but currently only a small minority of ED patients with opioid use disorder are started on medications. This study will refine and pilot an intervention called Talk About It which aims to foster patient-centered care, 'meet patients where they are' for addiction treatment, and increase treatment initiation and adherence via facilitating Shared Decision-Making in the ED around these potentially life-saving options.
Patients aged 16 and older
presenting with indications for Medications for Opioid Use Disorder (MOUD) initiation (opioid overdose, opioid withdrawal, complications of injection opioid use, untreated OUD)
not currently on buprenorphine or methadone (in the past 7 days).
No Opioid Use Disorder (OUD)
already on MOUD
Single group
Talk About It (conversation aid)
Behavioral"Talk About It" is a conversation aid aimed to increase awareness of options and prompt discussion.
Uptake of Talk About It (1)
Clinician report of number of times they utilized the Talk About It Tool in preceding 12 months
Uptake of Talk About It (2)
Number of paper versions of Talk About It tool shared with patients each month as monitored by research staff
Uptake of Talk About It (3)
Number of times the digital version of Talk About It is accessed for clinical care each month (webpage use monitoring software)
Uptake of Talk About It (4)
Number of times patient reports using Talk About It on follow-up survey
Knowledge/Awareness
Patients will complete a post-ED knowledge test developed by Steering Committee
Perception of clinicians' compassion
Patients will complete the Sinclair Compassion Questionnaire (SCQ) which assessed their perception of their clinician's compassion (5 questions, range 1-5, higher = better)
Perceived Stigma
Patients will complete a Modified Perceived Stigma of Addiction Scale (PSAS) which assess their perception of their clinician's stigma (Q1 binary, Q2-4, range 1-5 with higher = more stigma)
Attitudes towards methadone
Patients will complete the Attitudes About Methadone (OAM-5) to assess whether the intervention has changed negative attitudes about methadone
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