# CE24-012 - Rigorous Evaluation of California Policies to Disseminate Emergency Department-based Services for Opioid Use Disorder

> **NIH ALLCDC R01** · UNIVERSITY OF CALIFORNIA AT DAVIS · 2024 · $350,000

## Abstract

PROJECT SUMMARY
 Medications for opioid use disorder (MOUD) can reduce overdose mortality risk, and emergency
departments (EDs) have been urged to adopt policies and procedures to facilitate MOUD initiation for patients
with untreated OUD. In California, major state policy initiatives have supported the dissemination of CA Bridge
– an innovative ED-based substance use program emphasizing low-barrier, ED-initiated MOUD -- to most
California EDs from 2018-2022. CA Bridge’s outreach and training has targeted vulnerable subpopulations,
including Medicaid enrollees, non-White patients, and patients residing in rural areas.
 In response to the CDC’s call for rigorous evaluations of policies to address the overdose crisis, we will
use Medicaid enrollment, inpatient, outpatient, and pharmacy Transformed Analytic Files (TAF) from California
from 2018-2022 to conduct an observational analogue of a stepped-wedge trial among 186 California EDs that
implemented CA Bridge during this period (58% of all California EDs). We will evaluate both short- and longer-
term clinical impacts of CA Bridge implementation among Medicaid patients with OUD, and sub-analyses will
examine impacts on racial/ethnic and rural/urban disparities by examining these factors as potential effect
moderators.
 This project’s specific aims are: Aim 1) To determine the impact of CA Bridge implementation on rates of
MOUD initiation (within 3 days of index ED visits) among Medicaid patients presenting to the ED with OUD.
Aim 2) To assess whether CA Bridge implementation is associated with increased utilization of outpatient
behavioral health services (within 90 days of index visits) and continued MOUD use (up to 360 days after index
visits) among Medicaid patients presenting with OUD. Aim 3) To evaluate whether CA Bridge implementation
is associated with reduced risk of fatal and non-fatal overdose (up to 360 days after index visits) among
Medicaid patients presenting with OUD. For each aim, we will examine CA Bridge impacts on racial/ethnic and
rural/urban disparities.
 Study results will have national health policy implications, as federal and state policymakers seek
effective ED-based strategies to reduce overdose deaths. EDs nationwide are implementing programs to
respond to the opioid epidemic, including ~600 EDs that have already adopted CA Bridge protocols. This work
will inform researchers, clinicians, and program administrators regarding the strengths and limitations of
implemented programs emphasizing ED-initiated MOUD, enabling program adaptation to maximally reduce
overdose risk in the Medicaid population.

## Key facts

- **NIH application ID:** 10994020
- **Project number:** 1R01CE003673-01
- **Recipient organization:** UNIVERSITY OF CALIFORNIA AT DAVIS
- **Principal Investigator:** Joshua J Fenton
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2024
- **Award amount:** $350,000
- **Award type:** 1
- **Project period:** 2024-09-30 → 2027-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10994020

## Citation

> US National Institutes of Health, RePORTER application 10994020, CE24-012 - Rigorous Evaluation of California Policies to Disseminate Emergency Department-based Services for Opioid Use Disorder (1R01CE003673-01). Retrieved via MORVS 2026-10-25 from https://api.morvs.ai/grant/nih/10994020. Licensed CC0.

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