ED Observation for Opioid Use Disorder

This is a multicenter, randomized clinical comparative effectiveness trial (RCT) in which patients with untreated OUD presenting to a Northwell Health Emergency Department (ED), NYULH-Brooklyn, NYULH-Tisch, and Bellevue Hospital will be randomized (1:1) to be managed clinically through either a standard ED visit or an extended visit through ED observation (EDOU).

Inclusion Criteria: * Is 18 years of age or older * Is able to speak English sufficiently to understand study procedures * Has a history of non-medical opioid use * Is a potential candidate for ED-based MOUD treatment initiation and referral at the site as confirmed by clinical staff * s not receiving MOUD through ongoing formal addiction treatment or pain management at the time of index ED visit * Is willing to receive either standard ED care or enhanced ED care in EDOU depending on random assignment * Presents to the ED during study screening hours Exclusion Criteria: * Unwilling or unable to provide written/electronic informed consent/HIPAA Authorization for research procedures, including research visits at baseline and Day 30 and Day 90, and/or consent for the release of health records and data matching for a period of 2 years following enrollment and 1 year prior to enrollment. * Currently in jail, prison or any inpatient overnight facility as required by court of law or have pending legal action or that could prevent participation in the study * Presents from a medical-based extended care facility (e.g., skilled nursing facility) * Previous participation in the current study * Inadequate locator information (unable or unwilling to provide one unique mean of contact). * Has acute, severe medical, psychiatric, or concurrent substance use problem or meets other criteria that would exclude the patient (clinically) from placement in EDOU according to EDOU placement clinical protocols.