Despite the proven effectiveness of buprenorphine to treat opioid use disorder (OUD), it remains drastically underprescribed, The New York Times reports.

Experts cite various reasons buprenorphine has not been adopted more quickly – limited funding, onerous regulations in the past, doctors’ lack of familiarity with it, hesitation by hospitals and other health care providers to fully engage with the specialty of addiction medicine and persistent stigma.

Because buprenorphine is itself an opioid, many physicians avoid it reflexively. It is monitored by the Drug Enforcement Administration, which likely further bolsters doctors’ reluctance.

Some doctors around the country are on a mission to change all this. Bridge clinics that provide buprenorphine in the emergency department (ED) are demonstrating that good treatment for OUD exists, and doctors can deploy it easily in their EDs.

At Alameda Health System Bridge Clinic in California, patients can be treated with buprenorphine minutes after they show up, right in the ED, not in some distant wing of the hospital. The program forgoes nearly all the initial paperwork for people with substance use disorder. Substance use navigators locate long-term treatment programs, follow up on prescriptions, connect patients with the correct doctors for their other health problems, remind patients about appointments and generally try to keep them engaged in care. The program has become a regional and national model of how to initiate lifesaving care in the ED, a place that historically has not prioritized treatment of patients with OUD.