Why do patients decline buprenorphine from the emergency department?

Emergency department-initiated buprenorphine (EDIB) successfully doubles retention in treatment at 30 days when compared to referral alone. Unfortunately, only a minority of patients eligible and offered EDIB receive it.  The specific objective of this study is to systematically evaluate reasons why EDIB-eligible patients with OUD decline EDIB. This knowledge is imperative to public health efforts addressing the opioid epidemic, as results can be used to improve harm reduction interventions by addressing critical gaps for ED patients with OUD.