From Pilot Project to National Movement: How Bridge Is Reshaping Overdose Care
Written by Jordan Brandt, National Project Manager
On a busy night in Lake Charles, Louisiana, a patient arrived in the emergency department (ED) after an overdose. Not long ago, their care might have followed a familiar pattern: stabilize, discharge, hope for the best after giving the patient a list of treatment options.
Today, the patient may be started on buprenorphine – a medication that stops withdrawal and cravings – receive take-home naloxone to prevent a future overdose, and meet with a navigator who will walk beside them toward longer-term care.
This shift didn’t happen by accident. It’s the result of a fundamental rethinking of how EDs treat opioid use disorder (OUD) – work pioneered by the Bridge Center and now being implemented nationwide with the support of the Opioid Response Network (ORN).
Where the Story Began
In 2018, clinicians behind CA Bridge, now part of the Bridge Center, asked a simple but radical question: What if we treated opioid use disorder with the same urgency as heart attacks? After all, the mortality risk following an ED visit post-overdose is comparable to that of a ST-segment elevation myocardial infarction (STEMI), one of the deadliest types of heart attacks.
EDs already sit at the center of crisis care. Patients come in when risks are highest. But for people with OUD, the ED had long been a revolving door – life-saving stabilization followed by discharge back into the same risk environment.
CA Bridge proved something powerful: if EDs start medications for addiction treatment (MAT) immediately, connect patients to peer navigators, and create a culture of compassionate care, outcomes change. The next question was inevitable: Can this work everywhere?
Taking the Model Nationwide
Through the Bridge Starts program, an 8-week training and technical assistance curriculum, the Bridge Center began sharing these lessons across the country, empowering local EDs to adapt the model to their own communities, workflows, and realities. Since 2022, the reach has been extraordinary.
Across 20 states and the District of Columbia, Bridge Starts has trained 228 provider champions in 35 EDs. Those champions brought low-barrier medication protocols into emergency medicine environments where 1,739 providers deliver more than 1.73 million emergency patient interactions every year.
And the ripple effects don’t stop there.
States have since asked the Bridge Center to return and invest more intensively through separate funding. Through those avenues, Bridge has trained 163 additional champions in 22 EDs across four states, expanding the model into systems that see 736,000 patient interactions annually.
Put another way: in under five years, seeds planted through the Bridge Starts training program have the potential to touch almost 2.5 million emergency medicine patient interactions per year. Given that almost a third of patients in the ED screen positive for a substance use disorder, this has added a door to treatment for many who otherwise may not have found one. Behind each of these numbers are clinicians learning new workflows, administrators rethinking systems, and patients receiving a different kind of emergency care.
Louisiana: When a Spark Becomes a Movement
Take, for example, Louisiana.
In 2021, Louisiana recorded the third-highest overdose death rate in the country, with more than 2,400 lives lost. Data showed many of those individuals had recently interacted with emergency services or justice systems. Each of these interactions were a clear missed opportunity for intervention.
In 2022, through ORN support, the Bridge Center partnered with hospitals in Lake Charles to provide training and technical assistance to initiate buprenorphine and substance use navigators from the ED. What began as a local effort through Imperial Calcasieu Human Services Authority and the Region 5 Office of Public Health quickly grew into Louisiana Bridge, now led by the Louisiana Department of Health and recognized by the Centers for Disease Control and Prevention.
In Southwest Louisiana, overdose deaths have fallen by 54% since this pilot launched. ED-prescribed buprenorphine increased by 300%. Referrals to treatment rose by 400%.
Melissa Stainback, Regional Opioid Coordinator in Lake Charles and Louisiana Bridge Implementation Advisor, said, “At a time when the parishes [counties] around us were seeing increases in overdose mortality, the parish where we focused on efforts with Bridge saw a decrease of 35%—after just one year, which held steady in the second year. As of 2025, we have sustained a 54% decline in overdose mortality since our peak in 2021.”
Today, Louisiana Bridge is scaling rapidly. Funding from the Louisiana Department of Health brought the Bridge Center to train four additional hospitals in regions across the state. Ochsner Medical Center, Opelousas General Health System, Rapides Regional Medical Center, and St. Tammany Parish Hospital are now working to implement the Bridge model.
In addition, the state is aligning policy and funding to support Bridge adoption, using its Medicaid Managed Care Incentive Program to reward hospitals that implement the model and meet key metrics.
At the same time, a major national barrier has disappeared: the federal X-waiver requirement for prescribing buprenorphine is gone. What once required special certification is now standard practice.
The path from training to statewide transformation has never been clearer.
Be the Next Catalyst
The most powerful part of this story aren’t the numbers, important as they are. It’s the momentum Bridge is building.
Every trained clinician becomes a champion. Every champion influences a department. Every department can spark regional change. And sometimes, as in Louisiana, a region becomes a statewide movement.
Emergency departments see people at their most vulnerable. With the right tools and support, they can also see people at the start of recovery.
Learn more
If your hospital or health system is ready to take the next step, the Bridge Center is ready to help. Reach out to learn more about training and technical assistance.
The next chapter of this story could begin in your emergency department.