The RWJBarnabas Health (RWJBH) Institute for Prevention and Recovery (IFPR) will partner with Newark Beth Israel Medical Center (NBIMC), Clara Maass Medical Center (CMMC), RWJBH Medical Group, Integrity House, and The Center for Great Expectations (CGE) to implement SAMHSA FY 2022 Medication-Assisted Treatment - Prescription Drug and Opioid Addiction (MAT-PDOA) to expand and enhance access to medication for opioid use disorder (MOUD) for persons with an opioid use disorder (OUD) seeking or receiving MOUD. NBIMC and CMMC primarily serve the eastern and southeastern portions of Essex County, New Jersey, which is composed of urban communities and suburban towns. This area has disparities in socioeconomic status, health status, and access to services. Essex County has a larger proportion of African-American and Hispanic/Latino residents than New Jersey as a whole-38.0% of the population is non-Hispanic African-American and 23.3% of the population is Hispanic or Latino, compared to 12.6% and 20.4% statewide, respectively. New Jersey has struggled with the opioid overdose crisis in the past decade, with a 133.8% increase in drug overdose deaths from 2013 to 2021. Essex County has been particularly affected, with a 208.3% increase in the same timeframe. In 2021, Essex County had 407 suspected overdose deaths, the most in the state. In the same year, providers in the county wrote 243,920 opioid prescriptions, and law enforcement and emergency medical services administered naloxone 2,085 times, a fourfold increase from 2015. In 2020, Essex County had the second highest number of residents admitted for treatment for opioid use. The goals of the MAT-PDOA program are to: 1) increase the capacity of RWJBH staff to provide MOUD in combination with comprehensive clinically appropriate services for individuals with OUD seeking or receiving MOUD in the emergency department (ED), 2) increase the number of individuals with OUD receiving MOUD, and 3) decrease illicit opioid drug use and prescription opioid misuse among individuals with OUD receiving MOUD. The project will utilize three evidence-based practices (EBPs)-buprenorphine as treatment for OUD, the Emergency department-initiated Buprenorphine for opioid usE Disorder (EMBED) clinical decision support (CDS) intervention, and the Bridge model for buprenorphine initiation in the ED-to increase ED staff capacity to assess patients with OUD and provide MOUD, increase the number of patients receiving MOUD, and improve patient outcomes. The project proposes to serve 360 unduplicated individuals in Year 1, 420 unduplicated individuals in Year 2, 480 unduplicated individuals in Year 3, 540 unduplicated individuals in Year 4, and 600 unduplicated individuals in Year 5, totaling 2,400 unduplicated individuals served over the entire project period with grant funds. The project will measure progress towards goals and objectives by utilizing RWJBH's electronic health record and the GPRA tool.