The following is a summary of “Qualitative Exploration of Emergency Department Care Experiences Among People With Opioid Use Disorder,” published in the July 2023 issue of Emergency Medicine by Galarneau et al.
Researchers elucidated the experiences and preferences of individuals afflicted with opioid use disorder who seek emergency department (ED) services concerning ED care and interventions provided within the ED setting. From June to September 2020, researchers conducted telephone or face-to-face semistructured qualitative interviews with patients recently discharged from two urban emergency departments (EDs) in Vancouver, BC, Canada. These interviews aimed to investigate the patients’ encounters and preferences regarding ED care and interventions for opioid use disorder provided within the ED setting.
Participants were enlisted from a population of adults diagnosed with opioid use disorder who were actively engaged in an emergency department-initiated outreach program. Researchers accurately transcribed audio recordings word for word. They systematically developed a thematic coding framework, incorporating interim analyses to evaluate for thematic saturation. Two team members with a history of opioid use provided input on the study’s content, terminology, and commentary. They conducted interviews with a total of 19 participants. Participants reported experiencing discrimination due to substance abuse, resulting in a negative perception of healthcare quality and subsequent avoidance of emergency department utilization. Participants preferred receiving medical attention to those provided to non-substance-abusing individuals in the emergency department. They said they want to participate in their emergency department healthcare actively.
Participants nonetheless felt at ease discussing their substance utilization with emergency department (ED) personnel and appreciated the uninterrupted operating hours of the ED. Regarding treating opioid use disorder, participants expressed their endorsement of buprenorphine/naloxone programs implemented in emergency departments. However, they also proposed supplementary alternatives, such as diverse initiation regimens, settings, and other opioid agonist therapies. These suggestions aim to enhance the adoption of treatment options among individuals. Based on the observations of the participants, it is advised to address practices that may carry a stigma, enhance patient engagement in their healthcare during emergency department visits, and improve accessibility to diverse treatments for opioid use disorder and community support.