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ED-initiated buprenorphine, treatment continuity, and mortality: A statewide policy analysis

Award Number: K08DA065752
ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 05/15/2026
PERIOD OF PERFORMANCE END DATE: 04/30/2031

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ED-initiated buprenorphine, treatment continuity, and mortality: A statewide policy analysis - PROJECT SUMMARY This proposal outlines a five-year research and career development plan that will prepare Dr. Annette Dekker to become an independent physician-scientist. Dr. Dekker is an emergency physician and health services researcher committed to studying policy interventions that reduce opioid use disorder-related morbidity and mortality. The proposed study focuses on evaluating the role of health policy and the emergency department (ED) in initiating treatment of opioid use disorder, a critical intervention point for individuals at high risk of mortality. The project introduces the concept of the ED-Bup cascade—a continuum of prescriptions from ED-initiated buprenorphine to linkage to care to continuous treatment. Guided by the Donabedian framework, the study will assess how California’s CA Bridge initiative (structure) impacts the ED-Bup cascade (process) and subsequent mortality (outcome). Aim 1 will use a staggered difference-in-difference analysis to estimate the effect of CA Bridge implementation on the ED-Bup cascade for individuals who present to the ED with an opioid use disorder- related concern. Aim 2 will use a retrospective cohort study to evaluate how the ED-Bup cascade impacts mortality. Aim 3 will examine whether these patient outcomes vary by urbanicity. Analyses will use linked state- level claims, prescription drug monitoring program, and mortality data. The findings will inform state and national policies to address opioid use disorder morbidity and mortality. In this proposal, Dr. Dekker builds upon her prior experience in descriptive and mixed-methodological health services research to perform causal inference analyses of administrative data to understand the impact of California policy initiatives to increase low-barrier buprenorphine treatment from the ED. Her training plan includes developing advanced skills in 1) addiction health services research, 2) quasi-experimental and causal inference methods, and 3) health policy analysis through coursework and mentorship. She will be supported by her primary mentor, Dr. Elizabeth Samuels, who is a leader in ED-based addiction medicine, as well as a multidisciplinary team of co-mentors and advisors. Through UCLA’s Clinical and Translational Science Institute CTSI, Dr. Dekker will have access to numerous career development seminars that address such topics as grant writing, manuscript preparation, and ethical research. Throughout the proposed project, Dr. Dekker will have strong institutional support and access to UCLA’s renowned research infrastructure.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $169,776 )
2026	2026	UNIVERSITY OF CALIFORNIA, LOS ANGELES	10889 WILSHIRE BLVD STE 700	LOS ANGELES	CA	90024	LOS ANGELES	USA	Drug Use and Addiction Research Programs	000	1	5/7/2026	NEW	$169,776
														Subtotal = $169,776

Grand Total All Awards = $169,776

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ED-initiated buprenorphine, treatment continuity, and mortality: A statewide policy analysis

Award Number: K08DA065752

ORGANIZATION: NATIONAL INSTITUTE ON DRUG ABUSE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 05/15/2026

PERIOD OF PERFORMANCE END DATE: 04/30/2031

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