• Lexis R Galarneau, Frank X Scheuermeyer, Jesse Hilburt, Zoe R O'Neill, Skye Barbic, Jessica Moe, Jane A Buxton, Aaron M Orkin, Janusz Kaczorowski, Kathryn Dong, Dianne Tobin, Isabelle Miles, Misty Bath, Sherry Grier, Emma Garrod, and Andrew Kestler.
• George Spady Society, Edmonton, Alberta; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia. Electronic address: lexis@ualberta.ca.
• Ann Emerg Med. 2023 Jul 1; 82 (1): 1101-10.

Study ObjectiveWe described the experiences and preferences of people with opioid use disorder who access emergency department (ED) services regarding ED care and ED-based interventions.MethodsBetween June and September 2020, we conducted phone or in-person semistructured qualitative interviews with patients recently discharged from 2 urban EDs in Vancouver, BC, Canada, to explore experiences and preferences of ED care and ED-based opioid use disorder interventions. We recruited participants from a cohort of adults with opioid use disorder who were participating in an ED-initiated outreach program. We transcribed audio recordings verbatim. We iteratively developed a thematic coding structure, with interim analyses to assess for thematic saturation. Two team members with lived experience of opioid use provided feedback on content, wording, and analysis throughout the study.ResultsWe interviewed 19 participants. Participants felt discriminated against for their drug use, which led to poorer perceived health care and downstream ED avoidance. Participants desired to be treated like ED patients who do not use drugs and to be more involved in their ED care. Participants nevertheless felt comfortable discussing their substance use with ED staff and valued continuous ED operating hours. Regarding opioid use disorder treatment, participants supported ED-based buprenorphine/naloxone programs but also suggested additional options (eg, different initiation regimens and settings and other opioid agonist therapies) to facilitate further treatment uptake.ConclusionBased on participant experiences, we recommend addressing potentially stigmatizing practices, increasing patient involvement in their care during ED visits, and increasing access to various opioid use disorder-related treatments and community support.Copyright © 2023 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

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