Innovating Addiction Treatment

CA Bridge’s network of Centers of Excellence (COE) hospitals represents the nation’s most innovative laboratory for advancing real-world addiction treatment in the acute care setting. It also provides a vital clearinghouse for disseminating treatment best practices in California and beyond. This select group of hospitals includes high-performing facilities throughout the state collaborating to develop, refine, and share pioneering treatment solutions and training and educational resources.

The COEs have created a wide range of tools that support and extend the established framework of medication for addiction treatment (MAT). Here is what we’re working on: 

Fentanyl, MAT, and More

  • Buprenorphine Emergency Department Quick Start: The essential guide to treating patients in the ED, updated with the latest research and best practices. 
  • Buprenorphine Starts for Fentanyl Use: Clinicians nationwide are contending with an explosion of overdoses driven by fentanyl use and contamination. Hear from our clinical experts about treating patients who use fentanyl with buprenorphine.
  • Fentanyl Frequently Asked Questions: We often get questions about starting treatment for patients who use fentanyl. This FAQ provides helpful information about buprenorphine starts for patients who use fentanyl. 
  • Precipitated Withdrawal 90-Minute Bundle: Some physicians are reluctant to treat patients with buprenorphine due to the perceived risk of precipitated withdrawal. This guideline helps doctors understand how to handle precipitated withdrawal on the rare occasions when it does occur.
  • Starting Buprenorphine with Microdosing and Cross Tapering: Some patients may need to be eased into MAT. This clinical guideline describes how this can be accomplished so more patients can begin treatment, even if they’re not ideal candidates for the standard recommended dose of buprenorphine in the ED.
  • Methadone Quick Start: This resource provides treatment guidelines for patients presenting to the ED who prefer to start or are already being treated with methadone.

Stimulants and Other Substances 

  • ED Treatment of Problematic Methamphetamine Use: Methamphetamines are driving overdoses in California. COEs actively pilot promising treatment options to learn what works and how it can be adapted for the ED. 
  • Contingency Management (CM): One of the most effective treatment methods for stimulants is rarely offered to patients. This proven approach helps individuals break the cycle of stimulant addiction through weekly rewards designed to alter brain chemistry and mitigate drug dependence. Three COE hospitals are piloting initiatives that connect patients to CM in the ED, creating another open door to evidence-based care. 
  • Acute Care Treatment of Alcohol Use Disorder: How can we make naltrexone – an effective medication to treat withdrawal symptoms associated with alcohol use – more accessible? Learn how clinical leaders are pioneering the administration of this medication in the ED. 

Overdose and Harm Reduction 

Centers of Excellence